Over the past decade, Pacific Island countries have seen a rapid increase in HIV related activities that have largely been disconnected from broader sexual and reproductive health (SRH) activities. International research indicates that the synergies between HIV and SRH can be better used to improve health outcomes. However, despite a number of high level calls for greater linkages and integration, as well as the creation of avenues for this to occur, very little linkage and integration has yet been achieved at either policy or service levels in the Pacific region. Where it has, it remains limited and ad-hoc, often available only in urban areas and most often, dependent on donor funding and NGO implementation. Further, little information is available on exactly what is being linked and integrated and how effective it is. This report builds on efforts by Family Planning International and Population Action International, to identify linkage and integration activity around HIV and SRH in the Pacific region. Using a review of existing literature and interviews from papua New Guinea, the Solomon Islands, Fiji and Kiribati the report outlines barriers to, and entry points for, advancing HIV and SRH linkages and integration in the Pacific region.