About one million HIV-positive people in developing countries started to receive life-saving antiretroviral (ARV) drugs in 2007, according to a new report by UNAIDS, UNICEF and the World Health Organization. That brings to about three million the total number of people in developing countries who now have access to the drugs. But the tremendous progress that has been made in saving lives also brings with it significant challenges.
For many people able to access ARV treatment, HIV infection can now be managed as a chronic disease. 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. Given the rapid growth in the number of people receiving HIV treatment, meeting their sexual and reproductive needs should be an increasingly urgent priority. Doing so not only enables HIV-positive people to live healthy and fulfilling lives, but also is a core component of overall HIV prevention efforts that present the only long-term chance of defeating the disease.
A common challenge in addressing the sexual and reproductive health needs of HIV-positive people is the separation of programs that provide HIV services from those providing sexual and reproductive health services. Prevention of unintended pregnancy in particular is a critical, but largely overlooked, component of any prevention strategy, since so many HIV-positive women wish to delay or prevent pregnancy. Women of reproductive age account for more than half of the 33 million cases of HIV around the world.
Integrating the provision of voluntary contraceptive services into programs where HIV-positive women are going for HIV-related treatment is essential to making U.S. efforts to combat the AIDS epidemic more effective.
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