This document, targeted at health sector decision makers and sexual and reproductive health (SRH) and HIV/STI program and service managers, is the fruit of a series of intensive expert consultations organized by PAHO over the course of several months, with the participation of other United Nations agencies. This process has been geared to developing a work approach that not only increases the coverage of these programs and services but makes them more accessible to the segments of the population that need them the most. At the same time, greater use of these programs and services should result in a substantial reduction in problems associated with sexual activity and reproduction. HIV and other sexually transmitted infections are so important that the actions necessary to deal with them cannot be postponed. It is therefore essential to integrate them into the work of SRH programs and services. The gender dimension, which intersects with all facets of human life, is especially visible in the area of sexuality and reproduction. Thus, it has been regarded from the outset as an underlying aspect of the linkage between programs and services. It serves as the foundation for building connections and linkages that should result not only in fewer cases of HIV and other STIs but also in marked improvements in a variety of sexual and reproductive health indicators as well as indicators of the general sexual well-being of individuals, families, and communities.