Jim Shelton's Pearls

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January 20, 2004

Women of Reproductive Age and ART

As we begin to approach antiretroviral therapy in Africa, isn't it true that many of the candidates for ART will be women of reproductive age and thus many may have need for family planning?

Yes, in fact a majority of candidates for ART in Africa will probably be women of reproductive age. (Above and beyond the special category of preventing mother-to-child transmission)

1. Since HIV is primarily sexually transmitted in Africa, people of reproductive age are the largest group by far.
2. Moreover, infection rates in women tend to be higher than men. In national surveys including ones from Zambia, Mali, South Africa and Kenya women represent roughly 60% of those infected of reproductive age.

Thus taking into account the smaller proportion of HIV-infected individuals that are not of reproductive age (e.g. young children,) UNAIDS estimates that about 53% of people living with HIV/AIDS in Sub-Saharan Africa are women 15-49.

(Bear in mind that candidates for ART will be somewhat older than the average of the infected because ART is intended for those whose infection is advanced. However, since women in Africa tend to be infected as early ages, the vast majority of women would still be of reproductive age.)

And yes, clearly many of these women would need access to family planning services.

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The "Pearls" offer answers to commonly asked questions about family planning. These "Pearls" are prepared by Dr. James D. Shelton, Senior Medical Scientist, Office of Population, United States Agency for International Development (USAID)

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