HIV services need to go hand-in-hand with family planning, Kenya study says

HIV patients in Kenya cannot access family planning services, even though most women with the virus do not want children in the next few years.

Eighty per cent of HIV-positive women in Kenya’s Nakuru district in Rift Valley Province said they didn’t want to have a child in the next two years, according to a recent study by Family Health International (FHI). But only half the HIV-positive people needing family planning services had access to them, the 2007 Kenya AIDS Indicator Survey found.

Programmes focussed on preventing mothers passing on HIV to their babies are failing to see that family planning and preventing unwanted pregnancies is a big step towards this aim, Maurine Kuyo of FHI told the United Nations news service.

"Most prevention of mother-to-child transmission programmes ... looked at it only in the context of preventing transmission to an already conceived child, but meeting contraceptive needs of those living with HIV is a sure way of reducing ... transmission by avoiding unwanted pregnancies in the first place," she said.

One HIV patient said staff at the antenatal clinic she attends in Mukuru, a slum in Kenya’s capital, Nairobi, have not mentioned contraception, to her even though they know she and her husband already have three children. She herself says she is unwilling to use condoms, because she sees them as a contraceptive method for unmarried people who have several sexual partners.

"I know there are other family-planning methods, but we are not even told whether those other contraceptives are safe for somebody like me (HIV-positive) or not," she told the news service. She also said she is determined that her current pregnancy will be her last, even if it means seeking an illegal and possibly dangerous abortion.

About 56 per cent of women said their fear of passing HIV on to their children is one the reasons they would not want another pregnancy, the FHI survey found. Another 50 per cent of women with HIV said they wanted to avoid pregnancy because of the risk of lowered immunity.

"It is important to realize that we have a sexually active population, including people living with HIV, and this should be reason enough to strengthen family-planning programmes and integrate them into HIV and AIDS programs, including offering family-planning counselling at voluntary counselling and testing centres," FHI's Maurine Kuyo said.