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Sustainable Development Goal (SDG) 3 is to ensure healthy lives and promote well-being for all at all ages. The UN Global Strategy for Women’s Children and Adolescent Health has been developed with SDG 3 in mind. These represent a new beginning for the global development agenda in moving away from siloed, vertical approaches, and focus on comprehensive sexual and reproductive health and rights (SRHR), including HIV. Integrated, multidisciplinary responses are increasingly critical from economic, political and health systems perspectives; piecemeal approaches leave too many gaps in the elements left unaddressed. A strengthened focus on SRHR/HIV integrated healthcare service delivery can support the achievement of joint health outcomes and goes beyond a single disease to represent a more holistic perspective. Building upon global expert consultations to identify new approaches to catalyze HIV prevention in adolescent girls and young women (AGYW) in the context of comprehensive sexual and reproductive health and rights, a consultative, expert meeting was convened (Expert meeting on STI/HIV Prevention for Adolescent girls and Young Women), coconvened by the British Columbia Centre for Disease Control (BC-CDC) and the WHO Department of Reproductive Health and Research (WHO/RHR) in conjunction with the Fourth Global Symposium on Health Systems Research (16 November 2017; Vancouver, Canada)) to examine the lessons learnt from the introduction of the human papilloma virus (HPV) vaccine to AGYW that could be leveraged for antiretroviral (ARV)-assisted HIV prevention interventions in this population. For HIV prevention, oral pre-exposure prophylaxis (PrEP) is being implemented for women and key populations in several high HIV incidence countries through integrated programs, such as the DREAMS partnership of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Other ARV-based biomedical products include the dapivirine vaginal ring, and various multipurpose prevention technologies are innovations in various stages of development for HIV prevention for women and girls. However, despite the high efficacy of PrEP when used with fidelity, immense challenges remain for implementation to AGYW, including acceptability, access and adherence. HPV vaccine has faced similar uptake and distribution challenges for lowand middle-income countries (LMICs). HPV vaccination for adolescent girls is becoming much more widely available through The Global Alliance for Vaccines and Immunizations (GAVI) to low-income countries at a heavily subsidized cost. However, only a handful of countries with high rates of cervical cancer have HPV vaccination programs with high coverage rates. AGYW are consequently poorly served for both HIV and HPV prevention despite well-documented efficacious biomedical interventions. Other sexually transmitted infections (STIs) are also controlled with standard prevention and disease control programs based on case-finding, treatment and contact tracing. Primary prevention can be nurtured with condom advocacy and distribution, self-efficacy and gender-based sensitivity training and, for young men, voluntary medical male circumcision. Existing programmes for this population are often fragmented or are insufficiently implemented as part of an essential package of services and, therefore, presents significant challenges to strategic coordination, equitable service provision and quality assurance. The introduction of the HPV vaccine is now done in the context of cancer prevention with young girls in school-based programs; 9–13 year old girls being the main target of this two-to-three

transactions of the royal society of tropical medicine and hygiene

The case for integrated human papillomavirus vaccine and HIV prevention with broader sexual and reproductive health and rights services for adolescent girls and young women