Context: Benefits of Preventing Unintended Pregnancy

CONTEXT: BENEFITS OF PREVENTING UNINTENDED PREGNANCY Among HIV-infected women in sub-Saharan Africa, about 60–90% of pregnancies are unintended.1–3 Improving uptake and use of voluntary family planning (FP) among this group of women could help them and their partners have the families that they want. In addition, prevention of unintended pregnancy contributes to prevention of mother-to-child transmission of HIV (PMTCT) and reduces maternal and newborn illness and death. There are low rates of use of more effective contraceptive methods—sterilization, intrauterine device (IUD), subdermal implants, injectables and oral contraceptives—in sub-Saharan Africa in general and among HIV-infected individuals in particular.4, 5 Such low rates are due to lack of information about these methods, partner opposition, fear of side effects, and barriers to access. In particular, structural barriers, including the fact that most women obtaining HIV services who want contraceptive services are referred to a separate FP clinic, create an unnecessary obstacle to pregnancy prevention.