Family Planning in the Era of HIV/AIDS

The rapid spread of the human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS) that it causes has had repercussions in many aspects of people's lives. Among them, some contraceptive methods originally designed for fertility regulation are now seen primarily as methods for protecting against infection with HIV and other sexually transmitted diseases (STDs). Arguments for the use of the condom, for example, now often focus on the prevention of infection as much as, if not more than, on the avoidance of unwanted pregnancy. The increasing use of contraception and the growing incidence of STDs, including HIV/AIDS, have implications not only for individuals and the community, but also for fertility regulation policies and programmes.

Until 1997, the Programme had supported individual research projects on issues related to the dual risk of unplanned pregnancy and STDs through the research initiatives on "Acceptability of condoms", "Sexual behaviour and reproductive health", and the "Role of men in reproductive health". In 1997, however, the Programme developed a new initiative entitled "Family planning and sexual behaviour in the era of HIV/STDs" with specific focus on dual protection. Two projects are currently ongoing under this initiative. The first is a regional multicountry study which is being carried out in Kenya, South Africa, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. This study is entitled "Family planning and sexual behaviour in the era of HIV/AIDS and STDs". A second project, entitled "Pregnancy prevention among young married Thais in the era of HIV/AIDS" is to be carried out in Thailand.

The multicountry study in Africa is focusing on the interface between family planning and HIV/STD prevention in eastern and southern Africa. There are good grounds for believing that the region of eastern and southern Africa is on the brink of fertility transition, with fertility decline well established in a growing number of countries. Hormonal contraceptives are the most popular, but the use of condoms and other barrier methods for family planning is low, in spite of a heavy burden of STDs and a high prevalence of HIV seropositivity in many countries of the region—a situation that has profound implications for individuals, services, programmes and policies.

The specific objectives of the African study are to: (i) ascertain the perspectives of sexually active individuals about the dual risks of STDs (including HIV/AIDS) and unwanted pregnancy; (ii) investigate the strategies considered by sexually active individuals as appropriate, practical and effective to cope with these risks; and (iii) explore the opportunities for, and constraints on, changing behaviour, with particular emphasis on communication between partners. The overall aim of the study is to provide policy-makers and programme managers with insights into the perspectives and behaviours of sexually active men and women with respect to STDs, HIV/AIDS and reproductive intentions.

The first phase of the study has involved focus group research, which was conducted with a view to guiding the subsequent quantitative phase. This issue of Progress explores the concerns related to family planning and HIV and summarizes findings of focus group studies from Kenya, South Africa, Tanzania, Uganda, and Zambia.

Go to Progress