Jim Shelton's Pearls

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May 26, 2004

Contraception for PMTCT

We are beginning an effort here to prevent mother-to-child transmission of HIV by providing the antiretroviral drug Nevirapine to HIV+ women late in pregnancy, and to the infants in the early neonatal period. But it seems sensible to me also to try to prevent additional infant HIV infections by providing postpartum contraception to women who don't want to conceive. Does that make sense?

Definitely. In fact WHO and various partners have outlined a comprehensive approach that includes "4 elements":

1. Primary prevention of HIV infection;
2. Preventing unintended pregnancies among HIV-infected women;
3. Preventing HIV transmission from HIV-infected women to their children; and
4. Providing care for HIV-infected mothers and their infants.

So your concept of providing contraception for HIV+ women after they deliver falls squarely in element 2. It is also an example of good reproductive health care that should be offered to all women postpartum and thus in element 4 as well.

References:
WHO. Strategic approaches to the prevention of HIV infection in infants. Report of a WHO meeting. Morges, Switzerland, 20-22 March 2002.

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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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