Research shows family planning could save millions of women in Africa

Family planning is vital in sub-Saharan Africa where 900 children are newly infected with HIV every day.

Lack of family planning services for people living with HIV in sub-Saharan Africa is threatening millions of lives and livelihoods, according to research presented at the International Conference on Family Planning.

Of the 34 million people infected with HIV globally, over 22 million live in sub-Saharan Africa and 12 million of them are women of reproductive age. High fertility levels combined with the high number of women infected with HIV results in nine hundred children newly infected with HIV every day.

Family planning is vital as it helps prevent transmission of HIV from mothers to babies. Contraception is also very important for an HIV-positive woman as HIV is one of the major causes of maternal mortality.

Lack of contraception for people living with HIV from poor areas

At the conference in Addis Ababa on 13 November, researchers presented their latest studies on family planning among people living with HIV in Kenya, Tanzania, Zimbabwe and Ethiopia.

The five studies presented highlight a lack of information and access to family planning methods. For instance, research among people living with HIV in Ethiopia revealed that, out of 600 participants, half reported not using family planning methods at all.

Eliud Wekesa from Population Council Kenya presented a study of family planning use and need among HIV-positive men and women in Nairobi slums. People in poor areas are the least likely to use contraception, as pointed out by the study, which shows that 33% of HIV positive people living in slums lack access to contraception, which is higher than the 25% rate of the general HIV-positive population.

Combination of condoms and other contraception methods

Consistent, correct condom use provides a high degree of protection against unintended pregnancies and sexually transmitted infections. Most HIV transmission occurs because condoms are not used at all during sexual intercourse.

According to the United States’ Centers for Disease Control and Prevention, condom failure is estimated at 18%. Therefore, it is more effective to use a combination of two methods. Dual protection, the simultaneous use of an effective contraception method with consistent condom use, reduces the risk of unplanned pregnancy as well as the risk of HIV transmission and other sexually transmitted infections.

Dual protection is recommended for sero-discordant couples (where one partner has HIV and the other does not) and couples living with HIV. However, the studies presented highlight the fact that condoms were the only contraception method used by study respondents. This is shown by an analysis of modern contraception use among HIV-positive women aged 15-49 in Tanzania, presented by Damian Damian from Kilimanjaro Christian Medical Center. The study showed that the level of dual protection is estimated at 19%.

Service integration

All women – including those living with HIV – have the right to decide and to plan when and whether to have children. This is more important to women living with HIV as family planning helps prevent HIV transmission to their babies. This explains why family planning is recognized as one of the components of prevention of mother-to-child transmission programmes.

The need to ensure family planning is integrated with HIV services – and includes youth-friendly services – was a key issue discussed at last week’s conference, with the International HIV/AIDS Alliance and its partners presenting new findings from a global youth survey as part of its Link Up project.

By linking up services HIV-positive people can have complete information about and access to family planning services in order to fully enjoy their reproductive health.

Read more about sexual and reproductive health