title: Reproductive health and family planning needs among HIV-infected women in Sub-Saharan Africa.
abstract: OBJECTIVE
  Review key topics and recent literature regarding reproductive health and family planning needs for HIV-infected women in Sub-Saharan Africa.
  
  
  METHODS
  Electronic searches performed in PubMed, JSTOR, and Web of Science; identified articles reviewed for inclusion.
  
  
  RESULTS
  Most HIV-infected women in Sub-Saharan Africa bear children, and access to antiretroviral therapy may increase childbearing desires and/or fertility, resulting in greater need for contraception. Most contraceptive options can be safely and effectively used by HIV-infected women. Unmet need for contraception is high in this population, with 66- 92% of women reporting not wanting another child (now or ever), but only 20-43% using contraception. During pregnancy and delivery, HIV-infected women need access to prevention of mother-to-child transmission (PMTCT) services, a skilled birth attendant, and quality post-partum care to prevent HIV infection in the infant and maximize maternal health. Providers may lack resources as well as appropriate training and support to provide such services to women with HIV. Innovations in biomedical and behavioral interventions may improve reproductive healthcare for HIV-infected women, but in Sub-Saharan Africa, models of integrating HIV and PMTCT services with family planning and reproductive health services will be important to improve reproductive outcomes.
  
  
  CONCLUSIONS
  HIV-infected women in Sub-Saharan Africa have myriad needs related to reproductive health, including access to high-quality family planning information and options, high-quality pregnancy care, and trained providers. Integrated services that help prevent unintended pregnancy and optimize maternal and infant health before, during and after pregnancy will both maximize limited resources as well as provide improved reproductive outcomes.
authors: Department of Pediatrics, Stanford University School of Medicine, 555 Middlefield Road, Menlo Park, CA 94025, USA. cleas@stanford.edu
authors: Clea C
authors: CC
authors: Sarnquist
authors: Lisa
authors: L
authors: Rahangdale
authors: Yvonne
authors: Y
authors: Maldonado
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003267:Contraception; D003268:Contraception Behavior; D003657:Decision Making; D005193:Family Planning Services / Q000458:organization & administration; D005260:Female; D005298:Fertility; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008430:Maternal-Child Health Centers / Q000458:organization & administration*; D009035:Mothers; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000517:prevention & control*; D034121:Reproductive Health Services / Q000458:organization & administration
chemical_list: D019380:Anti-HIV Agents