Policy brief underscores sexual and reproductive health needs of people living with HIV
Despite the enormous challenge that AIDS still poses to global
health, for many people able to access antiretroviral treatment, HIV
infection can now be managed as a chronic disease. Against this
backdrop, a new policy brief from the Guttmacher Institute, entitled
?Meeting the Sexual and Reproductive Health Needs of People Living With
HIV,? emphasizes that people living with HIV do not lose their desire
to have sex and bear children, and outlines both the challenges and
benefits of better meeting these needs.
?Because sex and childbearing are central to the lives of almost
everyone, including those living with HIV, effective programs must take
into account the sexual and reproductive health needs and aspirations
of people living with HIV,? says Heather Boonstra, senior public policy
analyst at the Guttmacher Institute, who wrote the policy brief. Where
sexual and reproductive health services tailored to the needs and
circumstances of people living with HIV are in place, Boonstra notes,
?not only do the lives of people with HIV stand to benefit, but global
HIV prevention efforts will benefit as well.?
The policy brief
was published jointly by the Guttmacher Institute and the Joint United
Nations Programme on HIV/AIDS (UNAIDS) in collaboration with
EngenderHealth, the Global Network of People Living with HIV/AIDS
(GNP+), the International Community of Women Living with HIV/AIDS, the
International Planned Parenthood Federation, the United Nations
Population Fund (UNFPA) and the World Health Organization.
The policy brief examines a range of sexual and reproductive health
needs and aspirations of people living with HIV as well factors that
can limit access to such health care services, including:
weak health care systems, where staff may not have been trained about
HIV and sexual and reproductive health, and where supplies are often
lacking;
parallel programs separately focused on HIV services and on sexual and
reproductive health services;
taboos around sex, which impede the development of policies and
programs addressing the sexual health needs of all people, particularly
young people;
gender inequalities, which may lead to women?s lack of individual
autonomy and control over sexual experiences; and
HIV-related stigma and discrimination, including that among health care
providers.
"People living with HIV continue to have satisfying sexual lives
and make plans to have families," explained Kevin Moody, international
coordinator of GNP+. "However, stigma and discrimination; lack of
access to health workers trained in the sexual and reproductive health
of people living with HIV; and the inability for people to even talk
about sex make it difficult for people living with HIV to enjoy
satisfying sex lives or to plan to exercise reproductive choices that
are meaningful to them in their lives. The Guttmacher policy brief
describes these challenges and describes how involving people living
with HIV can help overcome them."
The brief underlines that people living with HIV may require
specific sexual and reproductive health services. For example,
compromised immune systems may leave people living with HIV
particularly vulnerable to some sexually transmitted infections. Also,
couples where one partner is HIV-positive face special challenges in
trying to become parents and need help preventing transmission of the
virus, and all HIV-positive women considering pregnancy need counseling
and services to prevent perinatal transmission.
Nevertheless, the evidence shows that HIV infection need not prevent
men and women from safely having sex, bearing children, using most
modern contraceptives or accessing abortion services where legally
available. The policy brief stresses that in designing policies and
programs to address the sexual and reproductive health needs of men and
women living with HIV, policymakers, public health experts and
national-level program planners must, of course, consider the best
available scientific data. To be successful, they must also take
advantage of the perspectives, expertise and accumulated experiences of
people living with HIV.
?Associations and networks of HIV-positive people and community-based
organizations run by and for people with HIV have a key role to play at
all stages in the process?from program and policy design to the
delivery and evaluation of sexual and reproductive health services,?
said Dr. Purnima Mane, UNAIDS? director of policy, evidence and
partnerships.
You can download the issue brief here
Hardcopies can be purchased from the Guttmacher Institute for $.25 each by sending an e-mail. Volume discounts are available.
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