Reproductive Health and Family Planning Needs Among HIV-Infected Women in Sub-Saharan Africa
Clea C. Sarnquist, Lisa Rahangdale and Yvonne Maldonado
Affiliation: Department of Pediatrics, Stanford University School of Medicine, 555 Middlefield Road, Menlo Park, CA, 94025, USA.
Keywords: HIV/AIDS in women, HIV prevention, family planning, pregnancy, preventing mother-to-child HIV transmission,
Objective: Review key topics and recent literature regarding reproductive health and family planning needs for
HIV-infected women in Sub-Saharan Africa.
Methods: Electronic searches performed in PubMed, JSTOR, and Web of Science; identified articles reviewed for
Findings: Most HIV-infected women in Sub-Saharan Africa bear children, and access to antiretroviral therapy may
increase childbearing desires and/or fertility, resulting in greater need for contraception. Most contraceptive options can
be safely and effectively used by HIV-infected women. Unmet need for contraception is high in this population, with 66-
92% of women reporting not wanting another child (now or ever), but only 20-43% using contraception. During
pregnancy and delivery, HIV-infected women need access to prevention of mother-to-child transmission (PMTCT)
services, a skilled birth attendant, and quality post-partum care to prevent HIV infection in the infant and maximize
maternal health. Providers may lack resources as well as appropriate training and support to provide such services to
women with HIV. Innovations in biomedical and behavioral interventions may improve reproductive healthcare for HIVinfected
women, but in Sub-Saharan Africa, models of integrating HIV and PMTCT services with family planning and
reproductive health services will be important to improve reproductive outcomes.
Conclusions: HIV-infected women in Sub-Saharan Africa have myriad needs related to reproductive health, including
access to high-quality family planning information and options, high-quality pregnancy care, and trained providers.
Integrated services that help prevent unintended pregnancy and optimize maternal and infant health before, during and
after pregnancy will both maximize limited resources as well as provide improved reproductive outcomes.
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