April 7, 2006

Family planning can curb spread of HIV: speaker

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Willard Cates Jr., M.D., M.P.H., left, talks with Vanderbilt’s William Schaffner, M.D., at last week’s lecture.
Photo by Anne Rayner

Family planning can curb spread of HIV: speaker

Contraception is “the best kept secret” in preventing the spread of HIV, a leading public health expert said last week during World Health Week at Vanderbilt University Medical Center.

In sub-Saharan Africa, where the AIDS epidemic has hit the hardest, contraception prevents the birth of 173,000 HIV-infected babies every year, said Willard Cates Jr., M.D., MPH, president and CEO of Family Health International's Institute for Family Health.

That's more than three times the number of babies who have avoided HIV infection since 1999 through the use of nevirapine, an AIDS drug given to prevent HIV-infected women from passing the virus to their children during delivery, Cates said.

In a recent study in South Africa, 84 percent of women attending prenatal clinics said their pregnancies were unplanned.

Expanding family planning services not only could avoid the birth of HIV-infected babies to mothers who did not want to have more children, but also could reduce the staggering number of maternal deaths, added Sten Vermund, M.D., Ph.D., director of Vanderbilt University School of Medicine's Institute for Global Health.

An estimated 250,000 African women die annually from complications of pregnancy and childbirth due to limited health services. It is likely that HIV-infected mothers experience higher complication rates from childbirth than uninfected mothers, Vermund added.

“Effective contraception for those HIV-infected women who don't want to get pregnant prevents more infants from becoming infected than nevirapine, and decreases the number of future orphans,” said Cates, former director of the Division of STD/HIV Prevention at the U.S. Centers for Disease Control and Prevention.

Unless family planning programs join forces with programs aimed at combating HIV and other sexually transmitted diseases, “we're not going to be optimizing what we can do in this field in order to prevent the unintended consequences of human sexuality,” he concluded.

Cates delivered one of four World Health Week lectures, sponsored by the Vanderbilt University School of Medicine and School of Nursing Committee on International Medical Education.