HIV-positive women need family planning services, study shows

HIV-positive women in western Uganda want fewer children than women not living with the virus, but often do not have access to family planning services, a new study reveals.



The study of 421 women in the district of Kabarole found that the probability of HIV-positive women wanting to stop childbearing was 6.25 times greater than it was for HIV-negative individuals.



“HIV-positive women tended to want fewer children than their HIV-negative counterparts mainly because they are aware of the risks of mother-to-child transmission and do not want to go through the difficulties associated with having an HIV-positive child,” said Walter Kipp, global health professor at the University of Alberta in Canada, and one of the study’s authors.



Statistics from the UN Children’s Fund show that in 2008, only 55 percent of HIV-positive pregnant women received antiretroviral treatment to prevent mother-to-child transmission; close to 30,000 Ugandan children are infected with HIV at birth every year.



Kipp noted that the survey’s results highlight the urgent need to integrate family planning into HIV services. “Family planning in Uganda is not well developed, and if women want to stop having children, often they have no access to contraceptive pills or other family planning methods,” he said.



According to the Ministry of Health, 41 percent of Ugandan women who would like to stop having children have no access to family planning services. The country has the third-highest population growth rate in the world; only Yemen and Niger have higher rates.



Kipp noted there was a need to harmonize the messages of family planning groups, which tended to recommend the use of hormonal contraception over condoms for contraception, and HIV groups, which emphasized condom use for prevention.



“For HIV-positive women, we would usually recommend dual protection, which is the use of both a hormonal contraceptive and condoms,” he added.



A recent analysis published in the Journal of the International AIDS Society found that family planning was cost-effective for preventing HIV transmission and unintended pregnancies and would also reduce infant and maternal mortality and result in fewer orphans.



The survey noted there was a need for education to inform the population on the benefits of family planning and end misconceptions around the subject.



“There is a belief that hormonal contraception can affect future fertility, and that it may lead to malformed children in the future,” Kipp said. “However, the main barrier that needs to be overcome is the lack of availability of these services for women who need them.”



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