Research shows urgent need for family planning services for people living with HIV
27 February 2007
Most people living with HIV wish to avoid pregnancy, according to research on communities in Zambia and India. But many of them urgently need comprehensive contraceptive information and services, including alternatives to condoms.
The research by the Health Communication Partnership (of which the Alliance is a partner) looked at how the HIV epidemic is affecting people’s reproductive health decisions. It provides a significant opportunity to understand what aspects of family planning and HIV prevention service integration are working and what needs to be strengthened.
Although it makes sense for programmes to try to combine reproductive health and prevention services, little has been known at the community level of how the HIV epidemic is affecting people’s reproductive health decisions.
The surveys in Zambia and India found evidence that access to HIV counselling and testing alongside comprehensive contraceptive counselling needs to be expanded in antenatal clinics. It should also be made available at health clinics, where both men and women can access services.
Those who want to have children also need improved prevention of mother-to-child transmission information and services.
The Alliance is one of five members of the Health Communication Partnership who are aiming to strengthen public health in low income countries through strategic communication programmes.
Their findings indicate that couples are choosing to have smaller families than in the past. In Zambia, the epidemic is limiting people’s childbearing regardless of their HIV status, whereas in India it is affecting only people living with HIV, who are having fewer or no children.
Concerns about leaving orphaned children behind, transmission to newborns, and negative health consequences for pregnant women are reasons given for limiting childbearing. In Zambia, people are also worried about infecting HIV-negative partners.
In both countries, women living with HIV say that condoms are often the only contraceptive method offered to them, leaving them vulnerable to unwanted pregnancies when their partners refuse to use condoms.
The findings will be used to develop recommendations for better integration of family planning and prevention services at community level, with Zambia taking the lead because of its already integrated health portfolio.
