196291 Contraception an effective but underutilized strategy in the fight against HIV

Monday, November 9, 2009

Rose Wilcher, MPH , Family Health International, Research Triangle Park, NC
Ward Cates, MD, MPH , Family Health International, Research Triangle Park, NC
Holly McClain Burke, MPH , Behavioral and Biomedical Research, Family Health International, Research Triangle Park, NC
Contraception to prevent unintended pregnancies in HIV-positive women is an effective strategy to prevent mother-to-child transmission of HIV (PMTCT). Moreover, linkages between the family planning (FP) and HIV fields are critical to meeting the reproductive rights and needs of people living with HIV. Unfortunately, increasing access to contraception has been an underutilized strategy in the fight against HIV, despite high levels of unintended pregnancies in countries where the burden of HIV is greatest. To understand why HIV programs are falling short in making FP a central component of prevention efforts, we reviewed the international policy environment, funding trends, and country-level programs addressing FP/HIV linkages. Substantial policy support exists for stronger linkages between the FP and HIV fields. However, translating this high-level support into quality integrated service delivery programs has been hindered by several factors. First, separate funding mechanisms for FP and HIV programs has driven the vertical organization of health ministries and service facilities and undermined coordination between the two fields. Second, U.S. policies rooted in idealogical debate resulted in the proscription of contraception as part of U.S. Government-funded HIV programs. Third, PMTCT programs are limited by their focus on reaching women who are HIV-positive and already pregnant. Finally, insufficient evidence exists to endorse a set of best practices for FP/HIV service integration. More explicit support for FP by major donors and policymakers, coupled with ongoing investments in research to identify effective FP/HIV practices, is essential if contraception is to take its rightful place among HIV prevention interventions.

Learning Objectives:
1) Describe the evidence supporting contraception as an effective HIV prevention strategy 2) Discuss key obstacles to widespread implementation of interventions to increase access to contraception among women and couples with HIV 3) Describe three strategies to overcome obstacles and improve FP/HIV integration efforts

Keywords: Contraception, Service Integration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conduct research in this area.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.