HIV/AIDS and reproductive health

Session Objective and content

• Objective: At the end of the session the participant should be able to Outline the impact of HIV and AIDS on reproductive health

• Content– Maternal and child morbidity and mortality– Recurrent pregnancy losses– Fertility/fecundity and HIV– Effect of pregnancy on HIV– Socio family issues

Maternal morbidity and mortality

Child morbidity and mortality

Western Europe

< 500< 500North Africa & Middle East

13 00013 000sub-Saharan

Africa

720 000720 000

Eastern Europe &Central Asia

1 0001 000East Asia & Pacific

3 0003 000South & South-East Asia

60 00060 000

Australia & New Zealand

< 100< 100

North America

< 500< 500Caribbean

7 0007 000

Latin America

10 00010 000

Total: 800 000

HIV and Pregnancy

• HIV may adversely affect the course of pregnancy

• More than 90% of paediatric AIDS cases due to MTCT

• Many children born to HIV positive parents will be orphaned when 1 or both parents die

• Women without HIV place themselves at risk of infection when trying to become pregnant

• Majority of women with HIV are of child bearing age

HIV and Fertility

• Prior STI and or PID• Decreased fertility after adjustment for lactation,

age, illness and STI• Fertility further reduced with symptomatic

disease or syphilis co- infection• reduced sexual activity with advanced disease

have• Increased pregnancy loss with HIV

Effect of pregnancy on HIV

• CD4 decline in pregnancy due to dilutional effect. CD4% remain stable

• Viral load remains stable in pregnancy• No significant difference in survival among HIV

positive women who become pregnant and those that do not

Consequences of Stigma in PMTCT

• Discourages women from accessing ANC services• Prevents access to HIV CT and PMTCT services• Discourages disclosure of HIV test results• Discourages acceptance of PMTCT interventions• Discourages use of recommended PMTCT safer infant-

feeding practices