Since women with HIV are a risk for those who have sex with them, it is critical that HIV programmes have sexual and reproductive health element in them. It is important that use of contraceptives, along with family planning advice, is a part of the counselling programme for women living with HIV.
Let us take a look at some essential features of contraception for women living with HIV:
Use of contraceptives and family planning counselling is important for HIV afflicted women. They should be made to use condoms and other contraceptives more often to prevent unwanted pregnancies. Research carried out in Zambia on 251 HIV affected couples showed that couples who are given contraceptives during counselling for HIV were more likely to initiate contraception than those who were referred to a clinic outside the facility.
Various data from 1988 to 2004, pertaining to HIV-related behaviour, were analysed in USA to find out the effect of providing information to HIV patients about preventing unprotected sex. It was found that with skill building through live demonstrations, role plays in correct use of condoms, interpersonal skills for communicating about safer sex and revealing the serostatus, the cases of unprotected sex reduced considerably in HIV patients. Such counselling and training was provided by healthcare providers, counsellors or trained HIV-positive patients.
26 studies on safety of hormonal and intrauterine contraceptive methods were reviewed. It has been found that the risk for HIV disease progression does not increase by using hormonal methods. On the other hand, women with HIV using hormonal contraception exposed themselves to a greater risk of acquiring STIs compared to women not using hormonal contraception. This was similar to the risk reported in women who are HIV-negative.
Over twenty thousand HIV-positive women in 15 primary clinics of Zambia were screened for prevention of cervical cancer along with HIV care and treatment. The screening clinics were located near the government run public health care centres but not in the HIV clinic so that the stigma of AIDS patients could be minimised. The results were favourable and it was clear that morbidity and mortality of women living with HIV can be reduced by integrating cervical cancer screening and treatment with HIV care.
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