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Reproductive Health Care
The majority of women with HIV are diagnosed during their reproductive years (ages 15-49). Access to comprehensive reproductive health care counseling and services is recommended for all women of child-bearing age living with HIV.
What is reproductive health care?
Reproductive health care is providers discussing reproductive intentions and options for acting on those intentions with all those living with HIV, especially with women of child-bearing age. These discussions, whether individually with a man or a woman or with couples, include family planning, healthy conception planning, and contraception, as well as how pregnancy can increase a woman’s risk of transmitting and acquiring HIV. For women who intend to become or are already pregnant, reproductive health care includes measures to prevent mother-to-child transmission of HIV. (For information on CDC guidance and recommendations for reproductive health care, refer to: http://www.cdc.gov/hiv/pwp/reproductive.html)
Why do it? What are the benefits?
- Provides contraceptive and family planning options plus healthy conception choices as part of comprehensive health care for women and men living with HIV
- Reduces transmission risks to her baby to less than 1% when a pregnant woman living with HIV receives appropriate care and treatment
What are some of the barriers to reproductive health care?
- Lack of comfort or competence to discuss sexual and reproductive health issues in the context of HIV infection with both women and men
- HIV and reproductive health care not effectively integrated
- Difficulty reaching women with substance abuse, mental health, or similar issues; adolescent girls; and migrant and homeless women
What are some strategies to improve reproductive health care?
- Educate male and female patients living with HIV about proper use of male and female condoms, safer sex options, and pre-exposure prophylaxis for negative partners
- Make discussions about sexual health and family planning and provision of Pap smears part of routine HIV care and relevant to living with HIV
- Encourage routine HIV testing of women’s uninfected male partners
- Review all contraceptive options for patients
- Explore artificial insemination and other healthy conception options with women who want to become pregnant and with their male partners
Who is involved to make it work?
Physicians and other medical care providers have particular responsibility for addressing reproductive health issues with people living with HIV. All service providers, however, should be prepared to refer patients to an appropriate source to ensure they receive sexual health and family planning counseling.