Unwanted Pregnancies among HIV-Positive Women: Current Levels of Unmet Need for Contraception and Future Demand for Family Planning and PMTCT Services in a High-Risk Group

Kiersten Johnson, Macro International Inc.
Priscilla A. Akwara, United Nations Children's Fund (UNICEF)
Shea Rutstein, Macro International Inc.

HIV-positive women have particular needs for contraception in addition to avoiding unwanted pregnancy: to protect their own health and to eliminate the risk of transmitting HIV to an infant. In 2004, the UN described a four-element strategy that corresponds to health care providers’ four opportunities to prevent mother-to-child transmission (PMTCT); the prevention of unintended pregnancies among HIV-positive women constitutes one of the four elements. While all four elements are essential for meeting the United Nations General Assembly Special Session 2010 goals, little programmatic or policy-related attention has been paid to the prevention of unintended pregnancies among HIV-positive women. This paper uses Demographic and Health Survey data to assess levels of unmet need for contraception, differentials in unmet need according to HIV serostatus and differentials in unmet need according to various demographic and background characteristics among HIV-positive women. We also explore future fertility desires among women with HIV and their implications for the demand for family planning and PMTCT services.