Globally almost 40 million people now live with HIV/AIDS. As more people live with HIV and AIDS, comprehensive care, treatment and preventative services are necessary to help them these people live longer and healthier lives. Recognizing the importance of safe water, sanitation and hygiene promotion in protecting and caring for PLWHA, some organizations are integrating hygiene improvement into their HIV/AIDS programs. Hygiene improvement is a comprehensive approach to reducing diarrheal disease by promoting improvements in key hygiene practices (hand washing, treatment and safe storage of water, and sanitation/feces management), improving access to safe water and sanitation technologies and products, and facilitating or supporting an enabling environment (improved policies, community organization, institutional strengthening, and public-private partnerships). Studies have demonstrated that improved hygiene practices can reduce the risk of diarrhea by 30 percent or more, improving the quality of life for PLWHA as well as their families.

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Evidence is growing on the effectiveness of integrating safe water, hygiene, and sanitation interventions into HIV/AIDS programs, but little specific programming guidance exists. This document expands on an earlier August 2006 version with concrete guidance for implementers of HIV/AIDS care and support activities. USAID/HIP and the World Bank Water and Sanitation Program developed these recommendations through extensive consultations with HIV/AIDS and water sector researchers and program implementers and a broad review of the literature from different sectors.

HIP_AEDcx.pdf  (468.5 kB)

To achieve the desired impact on diarrheal disease reduction and other improvements for families affected by HIV, program objectives and relevant ways of measuring those objectives must be clearly articulated by donors and program managers. This document offers a set of illustrative objectives and indicators that can be used to measure WASH integration activities. USAID Hygiene Improvement Project. December 2009.

M&E WASH Indicators for HIV Programs.pdf  (209.3 kB)

HIP’s information brief on "Integrating Hygiene Improvement into HIV/AIDS Programming to Reduce Diarrhea."

HIP HI and HIV-AIDS Integration Brief.pdf  (343.1 kB)

HIP's poster presentation on "Meeting the Hygiene, Safe Water and Sanitation Needs of People Living
with HIV/AIDS," prepared for the 33rd WEDC International Conference, April 2008, Accra, Ghana.

HIP HIV-AIDS WEDC 2008 poster presentation.pdf  (555.3 kB)

An adaptation and expansion of an earlier review written by Dr. Kate Tulenko of the World Bank/Water and Sanitation Program, this paper reviews the existing scientific and programmatic evidence, raises water, sanitation, and health (WASH) issues in the HIV and AIDS context that need further study to build the evidence base, assesses current WASH guidance through a review of national HIV/AIDS guidelines from five African countries, and identifies programmatic implications that home-based care programs and the WASH sectors must consider. This expanded version of the WSP review was developed as a background resource for home-based care and water and sanitation program managers who met in Malawi to discuss strategies for integrating HIV/AIDS and WASH objectives into the home-based care programs.

Lit. review on WASH for PLWHA and program implications.pdf  (1.1 MB)

This document, developed primarily for USAID missions preparing guidance on palliative care activities for HIV/AIDS programming, summarizes the evidence base, and concrete programming tips for integrating safe water, hygiene and sanitation into HIV/AIDS home-based care and orphans and vulnerable children programs.

Program Tips on HI and HIV-AIDS for USAID 6.07.pdf  (53.5 kB)