“We made a mistake. We disconnected HIV from reproductive health. We should never have done that because it is part and parcel,” Read more
The above is a statement given by Executive director of the United Nations Population Fund, Babatunde Osotimehin in a recent interview.
HIV and Family Planning
I have read several comments that have arisen from his speech and realized that there is need for individuals to act now to address both HIV and RH issues.
Whilst it may seem quite alarming for someone occupying such a position to publicly confess how the policy makers have failed in addressing HIV as a reproductive health issue;it is also worth noting that it is not too late to take remedial measures.
HIV and Family Planning:Females Suffer More
Women and girls continue to have the greatest vulnerability to HIV/STI infections.This is informed by several factors including their lower socioeconomic bargaining power in relationships.
This vulnerability has seen girls as young as 10years engage in sexual activity either due to environmental influence or poor strategies put in place to enhance their knowledge levels.The changes in the social fabric in many countries have seen an increase in number of youth exposed to reproductive risks like unwanted pregnancies,STI/HIV,and early deaths.
Despite this,many governments have not effectively developed strategies to help inform a reduction of these risks, both for women and girls.
Governments have failed to realize that:
“Family planning has a role in fighting the HIV-Aids epidemic, especially in preventing unwanted pregnancy among HIV-positive women and reducing mother-to-child transmission. Family planning should be available to all women, regardless of HIV status.” Erika Lawson
Females who are of reproductive age continue to suffer,given that in some clinics they cannot access family planning methods of their choice,or their husbands won’t approve of them using contraceptives,and in some instances the men are not willing to use condoms or undergo a vasectomy.
For women who are HIV positive,society expects them to give up on their desire to have children.This is despite the existence of proof that people living with HIV/AIDS(PLWHA) can have HIV negative children through use of ARVs both for the mother and the baby ,and by exclusively breastfeeding their babies for 6 months. As such many women tested HIV positive have resorted not to disclose their status to their partners for fear of being made to give up on their RH needs.
It is therefore critical for men to be involved in strategies geared towards fighting HIV and promoting use of family planning methods.
Male Involvement:HIV and Family Planning
Whilst it is the females that seem to suffer most,any intervention that isolates the men will not achieve desired results.This is so because:
- Most families are governed by the patriarchal system which vests all decision making power in men
- Women’s health seeking behavior is greatly informed by the level of support received from their male partners.
- Men also get affected by the RH needs of their wives and daughters,but can only offer support if well informed
With this is mind,it is highly unlikely that any achievement can be made in addressing HIV and family planning issues without involving men.
HIV and Family Planning:Alarming Results
Despite the importance given to HIV,many countries have limited resources allocated towards availing family planning services in all health facilities.Women in need of these services have thus been forced to look for resources to buy these off the counter.
In most situations,lack of support from men(mostly husbands),has seen many women opt for the injection as a family planning method.This is so because no one can know if one is using depo provera or not.
This preference is now short lived with the release of study findings on how Depo provera increases the HIV acquisition and transmission risks among women.According to the study,women using this family planning method are twice likely to acquire or transmit HIV compared to those who don’t use it.
Reason given as to why Depo increases HIV risks are two fold:
- the physiological changes it causes in the vagina and cervix.This increases a woman’s chances of contracting STIs like chlamydia and gonnorhoea
- for women already HIV positive,depo was found to increased the concentration of HIV in the vaginal fluid.This in turn make it highly likely for them to transmit HIV to their sexual partners.
Way Forward:HIV and Family Planning
With all the above,i do support Mr.Osotimehin view of how we failed by placing so much emphasis on prevention of HIV without giving due regard to family planning as a reproductive health need for both those infected by HIV and those uninfected.
It is time governments stopped developing parallel HIV and Family planning programs,but instead join efforts in integrating family planning into HIV programs and vice versa