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Little consensus exists about the optimal models of integration or about how best to achieve them, with the consequence that the term means different things to different stakeholders and takes a diversity of forms (Cates and Stone 1992; Lush et al. The tools for effective diagnosis of STIs at primary health care level are still lacking, uptake of voluntary testing and counselling for HIV has been limited, drug therapy for HIV is only now starting to become available in the most affected countries, and condom promotion for dual protection has proved to be an uphill struggle, at least among married and cohabiting couples (Oberzaucher and Baggaley 2002; Maharaj and Cleland 2004).

Notwithstanding this myriad of problems, the justification for integrated services remains overwhelmingly strong in countries with severe generalized STI/HIV epidemics, and their potential contribution to HIV/STI control has been spelt out repeatedly (Pachauri 1994; Fox et al. MCH/FP services are often women's main, and sometimes sole, contact with the health care system and thus offer unique opportunities for STI/HIV information, advice and services.

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