Family Planning Clinics Gear Up to Fight AIDS
In 1987, amid growing concern over the deepening AIDS crisis, the Centers for Disease Control recommended that all women seeking family planning services in clinics, hospitals or doctors’ offices receive counseling about AIDS and, if appropriate, testing for HIV. As described in a Perspectives special report published that summer, the proliferation of professional conferences, statements and guidelines reflected the medical community’s awareness that heterosexual and perinatal transmission of HIV were about to transform the AIDS epidemic. In fact, the rate of infection among heterosexual men and women was rising fast and would soon be double that among gay and bisexual men. This public health crisis had reached the doorsteps of the family planning community, and one big question was: How do clinic providers convince clients who do not believe they are at risk of HIV infection to take the necessary steps—such as using condoms and getting tested—to protect themselves and their partners?
At the time, one of the main challenges identified by public health groups was the need to educate patients attending clinics, including family planning clinics, about the risks of HIV transmission, but to accomplish this task, it was widely recognized that clinic staff themselves needed to be trained to provide HIV counseling and testing. In describing the role that providers must play in reaching men and women who may be unaware of the risks, the executive director of Planned Parenthood of New York City explained, “Family planning clinics ... are the first line of defense in terms of education about and diagnosis of HIV and control of AIDS in the heterosexual population.” The Perspectives special report detailed how this call to action was being echoed by many in the medical and reproductive health communities. As one medical epidemiologist in the Baltimore health department summed up the situation, the time had come for family planning providers to expand their role “beyond birth control to disease control.”