Commonality of HIV Infection and pregnancy Learning Objectives for this session Identify the causes and consequences of HIV infection and unintended pregnancy Explain the ways in which the causes and consequences of HIV infection and unintended pregnancy are similar or overlapping Explain how having an understanding of the root causes and consequences of unintended pregnancy and HIV infection can help us be better service provider. DRAFT ©MOH/JHPIEGO – September 2003

Commonality of HIV Infection and pregnancy The root causes of HIV infection and unintended pregnancy overlap and are both influenced by a variety of social, economic and biological factors. The consequences of HIV infection and unintended pregnancy affect far more people than the clients seeking services - they affect their families, children, sexual partners, and communities. If care providers understood the root causes and consequences of unintended pregnancy and HIV infection, we can start appreciating the social context that influences individual behavior. Armed with this knowledge we can be better counselors to our clients on how to prevent STI/HIV infections and unintended pregnancies. DRAFT ©MOH/JHPIEGO – September 2003

Some factors influencing the growth of the HIV/AIDS Epidemic

Group Work: The Problem Tree Problems-: HIV Infection and Unintended pregnancy The trunk of the tree represents the problem The roots represent the factors contributing to the problem (or causes) The branches symbolize the results (or consequences) of the problem. DRAFT ©MOH/JHPIEGO – September 2003

Commonality of HIV Infection and pregnancy Discussion points; What similarities do you see among the root causes of these two problems? Any differences? What similarities do you see among the consequences of these two problems? Any differences? Who is affected by the consequences in each? What kinds of interventions are needed to address the roots (causes) of these problems? What are your roles as a providers in addressing these problems? DRAFT ©MOH/JHPIEGO – September 2003

Commonality of HIV Infection and pregnancy DRAFT ©MOH/JHPIEGO – September 2003

DRAFT ©MOH/JHPIEGO – September 2003 HIV Infection - Causes Men having multiple sexual partners Young people’s lack of access to sexual health information and condoms Women's inability to communicate or initiate communication with partner(s) about sexual matters or desires, Women's inability to refuse sexual activities or to negotiate condom use Women’s biological vulnerability Lack of awareness,denial or education related to prevention of HIV Social circumstances that facilitate behaviors that increase the risk of infection: -Commercial sex work -Migrant work - Alcohol / Injection drug use -People having multiple sexual partners without using condoms - erratic availability of condoms Absence or inaccessibility of service that provide information about HIV prevention DRAFT ©MOH/JHPIEGO – September 2003

HIV Infection- Consequences Social isolation Orphans Increased medical expenditures Stigma and discrimination Job loss or loss of benefits Reduced income generating ability/opportunities due to illness Compromised immune system Progression to HIV disease and opportunistic infections Transmission of HIV to uninfected partners Transmission of HIV to baby (pregnant or breastfeeding woman) Marital discord or broken families DRAFT ©MOH/JHPIEGO – September 2003

Unintended Pregnancy - Causes Social pressure for women to have multiple children Women's inability to communicate or initiate communication with partner(s) about sexual matters or desires, Women's inability to decide the number of children and when she will have children Young people’s lack of access to FP information and services Fear of broken relationship if refusing to have child(ren) Fear of social rejection if not wanting to have child(ren) Shame or guilt for not wanting children in a society that highly values children Lack of awareness or education related to prevention of unintended pregnancy. Absence or inaccessibility of services that provide information about preventing pregnancy. DRAFT ©MOH/JHPIEGO – September 2003

Unintended Pregnancy - Consequences Financial hardship (food, clothing, education, health care) Limited income generating ability Emotional demands of childrearing Compromised health, if not well spaced (2-3 yrs) Marital discord or strained relationship Increased risk of induced termination of pregnancy with associated health risks (hemorrhage, infection, sterility, death) Potentially underdeveloped child(ren)--physically, emotionally, educationally. DRAFT ©MOH/JHPIEGO – September 2003

Integrate Family Planning and HIV Services HIV/AIDS Services DRAFT ©MOH/JHPIEGO – September 2003