Preventing Unintended Pregnancies
Reducing unmet need for family planning so that all women who do not want to become pregnant now or in the future have access to contraception could have a significant effect on preventing perinatal transmission of HIV -- in part because many women do not know their HIV status. "Increasing voluntary contraceptive use had been an underused approach, despite clear evidence that preventing pregnancies in HIV-infected women who do not wish to become pregnant is an effective strategy for reducing HIV-positive births... The lack of attention to contraception as an effective HIV prevention strategy is particularly disconcerting given that the evidence of contraceptive efficacy is juxtaposed by high levels of unintended pregnancies among women living with HIV. Unintended pregnancies account for 1458% of all births in countries where the burden of HIV is the greatest" (Wilcher et al., 2008: ii54).
"The broader benefits of reducing unintended pregnancies in women [living with HIV] extend beyond the prevention of new HIV infections in infants: women with access to family planning services are able to decide on the number and spacing of their children, to avoid induced abortion (safe and unsafe) and reduce their own chances of acquiring STIs as well as limiting their potential for onward transmission to sexual partners" (Saxton et al., 2010: 2371). Dual-use contraception -- using both condoms and an effective contraceptive method -- should be promoted for both HIV-negative and HIV-positive people who wish to avoid an unintended pregnancy (McCall and Vicol, 2011).
Additional information about contraception services for women living with HIV, along with linkages to HIV services can be found in Meeting the Sexual and Reproductive Health Needs of Women Living With HIVand Structuring Health Services to Meet Women’s Needs.