January 02, 2007 Voluntary Contraception to Prevent Maternal-to-Child Transmission of HIV
 It seems to me that family planning has the potential to prevent a substantial amount of maternal-to-child transmission (MTCT) of HIV. Has anyone looked at that systematically?
 Yes. Prevention of unintended pregnancies was a major means of preventing MTCT identified by a 2002 meeting organized by WHO. And there have been 3 modeling approaches that have all shown a substantial impact of contraception on preventing infant infections.
Thus, investigators from FHI conservatively estimate that while there were approximately 640,000 children newly infected in sub-Saharan Africa during 2003, that number would have been 813,000 without any contraceptive use – or 173,000 prevented in one year. To appreciate just how significant this number is, compare it to the total cumulative number of infant infections prevented through antiretroviral prophylaxis to pregnant women under the President’s Emergency Plan through March 31, 2006 – estimated at 65,100.
An additional benefit of preventing unintended pregnancies among HIV-infected women is that even if the child is not infected during pregnancy, one or both parents may not survive because of their HIV infection; thus the risk of orphaned children is lower.
Since approximately 25% of births in sub-Saharan Africa are unintended, the potential for contraception to prevent even more HIV infection is profound. The FHI investigators estimate it to be another 160,000 each year. So making voluntary contraceptive services readily available to HIV+ women is an important priority.
References:
1. Reynolds HW, Steiner MJ, Cates W. Contraception’s proved potential to fight HIV[letter]. Sex Transm Infect 2005;81:184-185.
2. Making a difference: Supporting antiretroviral treatment. http://www.state.gov/documents/organization/67502.pdf (accessed 12/29/06)
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Pearl Archive
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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