Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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Family planning and HIV: what next?

29
FEB
2012

Amon and Mwenzi Banda with their children, Zambia © the Alliance

As we mark International Women’s Day this year it is striking to see the recent debates taking place about family planning and of HIV risk, sparked in part by the recent release of the WHO technical statement on hormonal contraception and HIV, which emphasizes the need for dual protection and appropriate counselling for women.

Read more about the WHO's technical statement here

The Alliance is clear that male and female condom use is the only way to prevent both unwanted pregnancy and protect against HIV. Women have the right to make informed choices about their sexual and reproductive health using the most up to date and accurate information.

Yet this is not a new debate. Each year, 200 million women in the world become pregnant, and approximately 2.5 million of these women are HIV-positive.

HIV alone accounts for more than 61,000 maternal deaths annually and in 2009, 370,000 children were newly infected with HIV (that’s 1,000 every day). 

In fact, Millennium Development Goal 5, to improve maternal health, is one of the most off-track.

These developments force us to take a closer looking at the relationship between family planning, sexual and reproductive rights and HIV prevention in order to increase the availability, quality and access to family planning for men and women both living with and affected by HIV and AIDS. 

Women’s rights

In the past many HIV and family planning services have operated independently. There is a welcome shift and recognition that when done together, in partnership, there are stronger health benefits for women and their families.

Women have the right to choose the method of family planning and be protected from HIV and STIs. Those of us working in HIV and sexual and reproductive health have a responsibility to ensure that women have timely, accessible and accurate information about the safety and effectiveness of both family planning methods and STI and HIV prevention.

Working in partnership

The Alliance is working with Marie Stopes International (MSI) to join up family planning services with HIV prevention, care and treatment services. It’s an exciting partnership that will see women able to access comprehensive information and quality referrals for their sexual and reproductive health and HIV needs in a number of countries.

At the heart of the good practice protocols developed by the Alliance and MSI on integrating HIV services into MSI’s existing family planning services it clearly states that women must have access to a comprehensive  range of sexual and reproductive health and HIV services.

Implementing dual protection

This is particularly important as effective and quality family planning must include dual protection. Women, particularly in sub-Saharan Africa, primarily use longer lasting, invisible methods of contraception such as the hormonal injectables and implants but these methods need to be used together with male or female condoms. Only condoms protect against both unintended pregnancy, HIV and other STIs.

It is vital that women can protect themselves from HIV. We know biologically women are more vulnerable to HIV and this is compounded by poverty, poor education and gender inequality. While global HIV infection rates may have fallen, the numbers of women living with HIV have increased in every region of the world.

Increasing reach

Joining up family planning and HIV services (with a focus on community outreach) can result in increased effectiveness, efficiency and value for money through less duplication of effort and competition for scarce resources.

The Alliance’s experience of mobilising community based referral systems in countries like Uganda, Kenya, India and South Sudan on HIV, maternal and newborn child health and sexual and reproductive health has demonstrated how more people can receive accurate information and quality services.

Husband and wife, Amon and Mwenzi Banda, get their information from Bwafwano, a clinic in the outskirts of Lusaka, Zambia. “I learned about family planning after my first born,the clinic advised me about this,” says Mwenzi.

Bwafwano’s community health workers also visit the couples’ area. “They bring condoms to the house,” says Amon. “I’ve learned a lot about HIV and pregnancy.” You can read more about Amon and Mwenzi here.

As the policy and technical debates ebb and flow we must remember that it is women who are at the centre of it all.

Women must be able to access and choose from the full range of contraceptive methods to prevent unintended pregnancies and also protect themselves from HIV and STIs whoever they are, wherever they live, whether they are rich or poor.