HIV/AIDS and family planning services integration: review of prospects for a comprehensive approach in sub-Saharan Africa

Abstract

In most parts of the world, family planning and HIV-related services are usually offered separately. Family planning services, especially those that are government-supported, primarily serve married women and couples of reproductive age, while HIV-related services target individuals at higher-risk of exposure to HIV. However, the integration of family planning into HIV/AIDS programmes, or vice versa, would permit women of reproductive age who are infected or affected by HIV to benefit from family planning and/or HIV-prevention counselling and services. Sub-Saharan Africa is characterized by low modern contraceptive prevalence (below 20%), along with unmet needs for contraception, high use of abortion and the feminisation of HIV. Furthermore, the majority of children infected by HIV live in this region. The use of contraception would permit HIV-positive women to avoid unintended pregnancies and would reduce the number of children who are born with the virus. However, funding for family planning has decreased steadily over the last decade; the UNFPA recently reported that current assistance is less than half the amount needed. Donors more often support responses to HIV and AIDS, rather than other health interventions. This article reviews the difficulties and limitations facing the integration of family planning and HIV-related services. In addition, it suggests strategies to promote information for women and men of reproductive age about family planning, HIV prevention and referrals, including outside the context of health facilities.

Keywords: comprehensive primary healthcare; health service delivery; health service structure; HIV prevention; integrated services; public sector

African Journal of AIDS Research 2009, 8(4): 465–472