Family planning, AIDS care should go hand in hand

Twenty-five years into the AIDS epidemic and halfway through the initial phase of the President's Emergency Plan for AIDS Relief, there is increasing international consensus about the need to target women and girls. One area where the U.S. could make a real difference in women's lives has until recently been largely overlooked: integrating HIV/AIDS and reproductive health services. This presents important new opportunities for the U.S. AIDS program to become more effective and sustainable.

The International AIDS conference Aug. 13-18 in Toronto is an opportune moment for the U.S. and its partners to make this integration a higher priority.

More than 80 percent of HIV infections worldwide are sexually transmitted. Addressing reproductive health and HIV together would better serve the needs of clients and health care providers in a more comprehensive, cost-effective and efficient manner. This makes sense when you consider how women interact with the health system. Sexually active women who seek family planning need information about how to protect themselves from HIV infection, or how to access HIV services if they are infected. Women who seek an HIV test or who are already receiving HIV treatment need information about reproductive health and family planning, so they can make informed choices about contraception, childbearing, and staying healthy.

The benefits of integrated programs also serve U.S. policy goals on AIDS care, prevention and treatment. Integration helps reduce the number of babies born HIV-infected as well as the number of future AIDS orphans, while also keeping the mothers healthier and alleviating the burdens on families and communities. This is accomplished by expanding opportunities for women to learn their HIV status, providing treatment for HIV-positive pregnant women to prevent HIV transmission to their infants, and increasing family planning for HIV-positive women to prevent unwanted pregnancies.

During a recent trip to Kenya, where I was investigating promising integrated programs, an official of a U.S.-based organization in Kenya explained why integration makes sense to reach women and girls at risk: "When we think about HIV and reproductive health issues, it boils down to one thing: People have to have sex if they're going to get HIV, STIs, unplanned pregnancy. They have to have unprotected sex - it's the common denominator."