Contraceptives Count for HIV Prevention

Family planning programs also play a critical role in preventing primary HIV infection. Comprehensive family planning services educate women and men about STI transmission, and consistent and correct condom use. Research shows that lowering HIV infection rates among sexually active adults by one to five percent can in fact achieve the same reduction in infant HIV infections as nevirapine interventions.²⁶⁵ In 2007, an estimated 420,000 children (under 15 years) were newly infected with HIV, amounting to an estimated 2.5 million children living with HIV.²⁶⁶ The majority of these infections are occurring in sub-Saharan Africa and were acquired from mothers during pregnancy, labor, delivery or breastfeeding. Recognizing the need to identify and strengthen the linkages between family planning and HIV prevention in women and children, United Nations agencies outlined a broad approach for PMTCT in the Glion Call to Action, issued in 2004.²⁶⁷ [see Box 8: The Glion Call to Action].

BOX 8: The Glion Call to Action on Family Planning and HIV/AIDS in Women and Children

In an effort to strengthen the linkages between family planning and HIV prevention, United Nations agencies led a series of consultations. The Glion Call to Action emerged as the consensus document of the first consultation in May 2004.

To prevent HIV infection in women and children, the Glion Call to Action recommends a four-pronged approach that includes: (1) preventing primary HIV infection in women; (2) preventing unintended pregnancy among women with HIV infection; (3) preventing transmission of HIV from infected pregnant women to their infants; and (4) providing care, treatment and support to HIV infected women.

Family planning services are essential to the first, second and fourth approaches, and thus are a cornerstone of a comprehensive package for the prevention of mother-to-child HIV transmission (PMTCT).

Millions of Pregnancies Worldwide Are Unintended

Worldwide, millions of women become pregnant unintentionally each year. In Kenya, a Demographic and Health Survey found that over a five-year period, only 51 percent of births were planned.²⁶⁸ During a three-year period in Zambia, only 59 percent of births were planned.²⁶⁹ In South Africa, 84 percent of pregnancies among antenatal care clinics were unplanned.²⁷⁰ Among adolescents, the range of unplanned pregnancies is highest in Latin America and the Caribbean, and in some sub-Saharan African countries where up to 50 percent of adolescent mothers reported that their pregnancies were unplanned. Notably, the United States has the highest adolescent fertility rate of all developed countries, and 73 percent of young women ages 15 to19 giving birth in the U.S. report that their pregnancies were unplanned.²⁷¹

There is emerging evidence that women living with HIV and AIDS also experience similarly high rates of unintended pregnancies. A study in Côte d’Ivoire of 149 postpartum women living with HIV found that over half of their pregnancies were unwanted and roughly one-third were aborted.²⁷² Another study of 288 Tanzanian women living with HIV found that more than 55 percent of pregnancies were unintended.²⁷³

Family Planning Is an Urgent Priority

Today more than 120 million women say they would prefer to avoid a pregnancy, but are not using any form of contraception.²⁷⁴ If women who rely on traditional methods of family planning are included in the estimate of unmet need, the figure rises to 201 million women.²⁷⁵ Research shows that most women who are considered to have an unmet need for family planning say they intend to use contraception in the future.²⁷⁶ As the number of women in their reproductive years increases and desired family size decreases, the global demand for family planning will increase. At the same time, the continued threat of HIV and the increasing number of people living with HIV or AIDS—people who are living longer, healthier lives due to expanded access to treatment—is leading to an increased need for condoms and other contraceptives.

Please see the Appendix for this section's end notes.