XIX International AIDS Conference

THSY04 Hormonal Contraception: The Role of Fertility Choice in HIV Prevention
  Symposia Session
Venue: GV Session Room 1
Time: 26.07.2012, 11:00 - 12:30
Chair: Helen Rees, South Africa
All women irrespective of their HIV status have a right to make reproductive choices and to access fertility counselling and contraceptives. Once pregnant, women have a right to effective antenatal care appropriate for their HIV status. For women planning a pregnancy, consideration must be given to their current HIV status, and for HIV negative women their risk of exposure to HIV. With PrEP as a possibility, the package of interventions for safe conception appropriate to the resource level of the health service must be now be considered. The use of contraception is a powerful public health intervention which reduces maternal mortality, improves infant and child outcomes, impacts on PMTCT and empowers women. In the context of significant HIV risk, consideration must be given to the risk of HIV acquisition, HIV transmission to an uninfected partner, the impact on HIV disease progression and drug interactions between hormonal methods and ARVs. In this session, the current evidence based thinking on all these issues will be presented and the rights framework outlined.
Webcast provided by The Kaiser Family Foundation


Contraception and HIV acquisition (HIV/HC)

W. Cates, United States

Fertility and HIV

V. Black, South Africa

Pregnancy and HIV acquisition

N. Mugo, Kenya

Sexual and reproductive health rights for HIV-positive women

A. Namiba, United Kingdom

Questions and answers


Powerpoints presentations
Contraception and HIV acquisition (HIV/HC) - Ward Cates

Fertility and HIV - Vivian Black

Pregnancy and HIV acquisition - Nelly Mugo

Sexual and reproductive health rights for HIV-positive women - Angelina Namiba

Rapporteur report

Track C report by Nora Rosenberg

This session addressed a range of sexual and reproductive health issues relating to fertility intentions and HIV. Ward Cates described evidence suggesting hormonal contraception may increase the risk of HIV acquisition among HIV-uninfected women, as well as the need for stronger evidence in this area. He also discussed evidence suggesting pregnancy may increase risk for HIV acquisition. The possibility of both hormonal contraception and pregnancy increasing risk for acquisition poses a difficult dilemma for women. Nelly Mugo also discussed the relationship between pregnancy and HIV acquisition and HIV transmission based on the Partners in Prevention HSV/HIV Transmission Study. Elevated HIV acquisition among HIV-uninfected pregnant women (HR: 1.6; CI: 0.9, 2.9) and elevated HIV transmission among HIV-infected pregnant women were seen (HR:2.3; CI: 1.2, 4.4). Vivian Black discussed options for HIV-infected persons and HIV-affected couples who would like to conceive. Strategies were suggested for promoting conception while minimizing the risk of sexual and mother-to-child transmission. Angelina Namiba discussed the role of fertility choices from the perspectives of an HIV-infected woman and mother, as well as advocate. She emphasized sexual and reproductive rights as a critical perspective for framing these questions.

Several key themes emerged from the panelists and audience. All panelists emphasized that decision-making must start with the HIV-infected woman who has the right to make informed choices about her own fertility. Finding ways of involving men was another theme that came up several times. Finding effective ways of integrating HIV and reproductive services was discussed, as well as the critical role of health care providers. Finally, there is a need for further investigation: this area has not received the research attention it requires.


    The organizers reserve the right to amend the programme.

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