Women who are pregnant or who have recently given birth face increased vulnerability to HIV. Physical changes increase susceptibility to infection. Abstinence or infrequent sex during this time may lead to male partners seeking sex with other partners. Condom use in marriage is not commonplace and less likely to be used during pregnancy since condoms are associated with contraception.
Thus dealing with HIV within the context of pregnancy must be an important focus of HIV prevention efforts. However, to date the focus has been primarily on preventing vertical transmission of HIV from a pregnant woman living with HIV to her infant. By 2004 only an estimated 8 per cent of all pregnant women in middle-and low-income countries were offered these services. UNFPA, along with the rest of the international community, recognizes that an effective response requires a much more comprehensive, four-pronged approach:
Prevent HIV infection among girls and women
Prevent unintended pregnancies among women living with HIV
Reduce mother-to-child transmission through antiretroviral drugs, safer deliveries and infant feeding counselling
Provide care, treatment and support to women living with HIV and their families.
All four of the elements are essential for meeting the UN goals for reducing the proportion of infants infected by half by 2010 (compared to 2001 figures), as called for in the UNGASS Declaration of Commitment.
The first two elements are the most effective ways to reduce the risks of transmission to infants, and they also have intrinsic benefits to women. In some countries, the proportion of infants infected by HIV could be reduced by 35 to 45 per cent through these two measures alone, as noted in the Glion Call to Action on Family Planning and HIV/AIDS in Women and Children.
Linking HIV/AIDS prevention, treatment and care with existing and intensified reproductive health services – including family planning, management of sexually transmitted infections, and maternal health – will play a major role in safeguarding the health of women and girls.