What Works for Women and Girls

What Works—Meeting the Sexual and Reproductive Health Needs of Women Livingwith HIV1. Promoting contraceptives and family planning counseling as part of routine HIVservices (and vice versa) can increase condom use, contraceptive use, and dualmethod use, thus averting unintended pregnancies among women living with HIV.2. Hormonal contraception is safe for women living with HIV and does not seem toaffect HIV acquisition or HIV progression.3. Women with HIV can use IUDs if they have access to medical services in case of IUDexpulsion.4. Providing information and skills-building support to HIV-positive people can reduceunprotected sex.5. Interventions to support disclosure can increase condom use in discordant couples.6. Providing antiretroviral treatment to people living with HIV can increase HIVprevention behaviors, including condom use.Promising Strategies:7. Cervical cancer screening and treatment can be integrated into HIV care to reducemorbidity and mortality in women living with HIV.8. Promoting condom use for contraception may make condom use more acceptableand easier to negotiate.9. Early postpartum visits can result in increased condom use, contraceptive use, HIVtesting and treatment.EVIDENCE1. Promoting contraceptives and family planning counseling as part of routine HIV services(and vice versa) may increase condom use, contraceptive use, and dual method use, thusaverting unintended pregnancies among women living with HIV. [See also Chapter 13.Structuring Health Services to Meet Women’s Needs]A three-armed randomized controlled trial at a VCT clinic in Lusaka, Zambia with 251couples found a threefold higher contraceptive initiation rate where family planningeducation and offer of contraceptives were available on site rather than by referral to anoutside clinic. All couples received a presentation on family planning methods and theWHAT WORKS FOR WOMEN AND GIRLS189