PEPFAR Achievements Deserve Applaud, But More Focus Should Be Afforded To Meeting Contraceptive Needs Of Women Living With HIV

“In recent weeks, global health policymakers, implementers, advocates and others have been celebrating the 10th anniversary of [PEPFAR],” Ward Cates, president emeritus with FHI 360; Rose Wilcher, a technical adviser with the research utilization team at FHI 360; and Heidi Reynolds, deputy director for HIV/AIDS and other infectious diseases for the MEASURE Evaluation Project based in the Carolina Population Center at the University of North Carolina at Chapel Hill, write in the Huffington Post’s “The Big Push” blog. “At the heart of these celebrations has been attention to the incredible gains that have been made in preventing mother-to-child transmission of HIV (PMTCT),” they state, adding Secretary of State John Kerry marked the anniversary by noting one million infants have been born free of HIV as a result of PEPFAR efforts. “But this isn’t the full story,” they state, adding, “As we applaud the milestones associated with greater access to [antiretroviral (ARV)] prophylaxis for PMTCT, we should also take stock of how meeting the contraceptive needs of women living with HIV also contributes to fewer infections among children and better outcomes for mothers.”

“Closer examination of data from several studies suggests that many of the women who have benefited from ARV prophylaxis during and immediately after pregnancy did not want to become pregnant in the first place,” they continue, noting, “Although the numbers vary across studies, about two-thirds of HIV-positive women report that their most recent pregnancies were unintended.” They state, “Stronger efforts to prevent unintended pregnancies among women with HIV — through both renewed commitments to increase access to contraception globally and better integration of family planning services into HIV platforms — will not only accelerate progress toward eliminating HIV transmission to infants, but also minimize the risks that unintended pregnancy poses to HIV-positive women.” They conclude, “As family planning interventions become a more routine component of HIV programs, hopefully future PMTCT milestones reported by PEPFAR will highlight not only the number of infants born free of HIV, but also the number of women living with HIV whose need for family planning has been met” (7/3).

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