Ford Nathan, Newman Morkor, Malumo Sarai, Chitembo Lastone, Gaffield Mary E
Department of HIV, Viral Hepatitis and STIs, World Health Organization, Geneva, Switzerland.
Department of Reproductive and Women's Health, World Health Organization, Lusaka, Zambia.
Front Glob Womens Health. 2021 Oct 1;2:735281. doi: 10.3389/fgwh.2021.735281. eCollection 2021.
Among the 1.9 billion women of reproductive age worldwide in 2019, 1.1 billion need family planning and 270 million have an unmet need for contraception. For women and adolescent girls living with human immunodeficiency virus (HIV), using effective contraception reduces the mother-to-child transmission of HIV by preventing unintended pregnancies and enabling the planning and safer conception of desired pregnancies with optimal maternal and child health outcomes. The World Health Organization (WHO) recommends that sexual and reproductive health services, including contraception, may be integrated within HIV services. Integration is associated with increased offers and uptake of sexual and reproductive health services, including contraception, which is likely to result in improved downstream clinical outcomes. Integrating HIV and sexual and reproductive health services has been found to improve access, the quality of antenatal care and nurse productivity while reducing stigma and without compromising uptake of care. Research is encouraged to identify approaches to integration that lead to better uptake of sexual and reproductive health services, including contraception. Implementation research is encouraged to evaluate different strategies of integration in different health systems and social contexts; such research should include providing contraception, including long-acting contraception, in the context of less frequent clinical and ART refill visits.
2019年，全球19亿育龄妇女中，有11亿需要计划生育服务，2.7亿有未满足的避孕需求。对于感染人类免疫缺陷病毒（HIV）的妇女和少女而言，使用有效的避孕措施可通过预防意外怀孕，并使她们能够规划并更安全地怀上理想的宝宝，从而实现最佳的母婴健康结果，进而降低HIV的母婴传播风险。世界卫生组织（WHO）建议，包括避孕服务在内的性与生殖健康服务可纳入HIV服务体系。这种整合与性与生殖健康服务（包括避孕服务）的提供增加和利用率提高相关联，这可能会改善下游的临床结果。研究发现，整合HIV与性与生殖健康服务能够改善服务可及性、提高产前护理质量以及护士工作效率，同时减少耻辱感，且不影响医疗服务的利用率。鼓励开展研究，以确定能够提高性与生殖健康服务（包括避孕服务）利用率的整合方法。鼓励开展实施研究，以评估在不同卫生系统和社会背景下的不同整合策略；此类研究应包括在临床和抗逆转录病毒治疗复诊次数较少的情况下提供避孕服务，包括长效避孕措施。
