Field Notes: 2013 Family Planning Conference Offers Insight Into Linkages with HIV-infection
Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) Research Officer Michelle Gill attended the 2013 International Conference on Family Planning in Addis Ababa, Ethiopia, Nov. 12-15, 2013. A key topic at this year’s conference was how to improve efforts to integrate family planning with HIV services.
Last month, more than 3,300 participants from 120 countries gathered in Addis Ababa, Ethiopia, for the 2013 International Conference on Family Planning. The mission of this year’s conference was “Full Access, Full Choice,” which includes expanding access to family planning for 120 million women in low-resource countries by 2020. As Melinda Gates noted in the opening plenary, “our goal is bold, but it’s achievable.”
Comprehensive and voluntary sexual and reproductive services help to improve maternal and child health through various methods such as delaying, limiting, or spacing pregnancies and preparing for a safe pregnancy and delivery. Family planning programs have been proven to reduce infant and maternal deaths and new HIV infections among children, as well as decrease abortion rates. During Roy Jacobstein’s presentation, he told us that there is a 1-in-39 risk of maternal death from pregnancy or childbirth in sub-Saharan Africa.
In the same session, Scott Radloff discussed how 24 percent of women around the world have unmet family planning needs. That figure jumps to 54 percent when the focus turns to women in low-resource countries. Radloff said that countries with the lowest contraceptive use and highest unmet need can be found in Africa, particularly in West and Central Africa, where 51 percent of unmarried women experience unmet family planning needs.
Several conference sessions addressed the crucial need for integrated family planning and HIV services in various settings, such as HIV counseling and testing, HIV care and treatment, and prevention of mother-to-child transmission (PMTCT) of HIV. Perhaps the most convincing evidence of the effectiveness of such integration was made by Daniel Grossman (presented by Craig R. Cohen), whose team conducted the first randomized control trial to evaluate family planning/HIV integration effectiveness in the Nyanza Province in Kenya. The researchers found an increase in use of effective family planning methods, (such as sterilization, implants, intrauterine devices, and injectable and oral contraceptives) among women also receiving HIV care and treatment services when compared to women in control sites who were offered family planning services through referrals to a separate maternal and child health clinic.
Other family planning/HIV integration studies presented at the conference acknowledged the great potential for high quality service provision and reduction in missed opportunities with an integration approach, but highlighted areas for improvement and further investigation. This included how to increase condom and dual method use (strategies to prevent both unwanted pregnancy and sexually transmitted infections) following integration—as well as how to address increased provider workload, and how to improve drug supply and distribution systems.
Overall, delegates at the conference recognized the crucial link between family planning and HIV services and were hopeful that research in the area will lead to highly effective and broad-reaching integration approaches.
Michelle Gill is a senior research associate for EGPAF.