Integrating family planning with antiretroviral therapy services in Uganda.

In Sub-Saharan Africa HIV affects women disproportionately particularly young women. In many of the worst-hit countries of the region 10% to 30% of pregnant women are HIV-positive (UNAIDS). Family planning (FP) can help ease the burden of HIV and limit new occurrences of HIV infection by decreasing unintended and unwanted pregnancies in HIV-positive women thereby preventing the transmission of HIV from mother to child. Not only is FP the most effective measure in the prevention of mother-to-child transmission of HIV (PMTCT) but it also improves the health and well-being of families by facilitating the spacing or limiting of births. Additionally condoms-an FP method-prevent transmission of HIV to a partner. FP is an integral component of safe and comprehensive HIV treatment and care services. However it is often overlooked as a preventive measure as the health care systems focus is primarily on offering curative care or responding to the medical and social needs of HIV-positive women and couples. In addition society has often presumed that people living with HIV (PLHIV) should not have sex or bear children. However now that HIV is becoming more controllable due to the increased access to antiretroviral therapy (ART) an increasing number of PLHIV are living longer and fuller lives and planning families. They have the same right to and need for comprehensive safe and effective FP as their uninfected peers. Meeting the FP and reproductive health rights and needs of PLHIV should be a high priority. The World Health Organization (WHO) has taken an important step by updating its international guidelines and including contraceptive methods that can be used by HIV-positive women. (excerpt)