Preventing Unintended Pregnancy, HIV, and STIs
Providing Contraceptive Guidelines
Since 1994, CDC’s Division of Reproductive Health (DRH) has provided assistance to the World Health Organization (WHO) to develop and update WHO’s authoritative contraceptive guidelines for family planning providers based on scientific evidence. WHO uses this information to update their guidelines, the Medical Eligibility Criteria for Contraceptive Use and the Selected Practice Recommendations for Contraceptive Use. CDC has adapted these guidelines for use in the United States.
CDC monitors, assesses, and synthesizes new research on contraceptive safety and efficacy using the CIRE (Continuous Identification of Research Evidence) system. The CIRE system was developed by CDC/DRH, WHO, and Johns Hopkins University to facilitate the process of providing WHO with the best evidence in a timely manner. This system allows CDC/DRH to—
- Identify new evidence as it is published.
- Conduct systematic reviews and meta-analyses.
- Solicit peer reviewer feedback on the systematic reviews and the need to update guidance.
- Present the evidence and feedback to WHO.
WHO then holds expert meetings to decide if and how to adapt their guidance on the basis of the new findings.
Assessing Your Program's Contraceptive Supply Needs
Every family planning program must have a good supply of contraceptives on hand at all times. To help countries and programs calculate the quantity of contraceptives they need, CDC has developed the CastCost (Contraceptive Forecast and Cost Estimate) tool. This user-friendly spreadsheet uses data from Reproductive Health Surveys (or Demographic and Health Surveys) to estimate the quantity and cost of contraceptives that will be needed in a country or by a family planning service provider for each of the next five years. The CastCost tool is available in both English and Spanish. Read about our past work in Contraceptive Logistics.
Preventing Maternal to Child Transmission (PMTCT) is an HIV prevention approach with four components:
- Preventing primary HIV infection among women of childbearing age.
- Preventing unintended pregnancies among women living with HIV.
- Preventing HIV transmission from a woman living with HIV to her infant during pregnancy, labor, delivery, or breastfeeding.
- Providing appropriate treatment, care, and support to mothers living with HIV and their children and families.
DRH is engaged in several PMTCT activities:
Integration of family planning and PMTCT in Russia and Ukraine
In Russia, CDC/DRH has been involved in a study to prevent unintended pregnancies in HIV-positive women. Most women never wanted to become pregnant in the future or were uncertain that they ever wanted children. This study involves investigating the safety and effectiveness of long-term contraceptives for HIV-infected women, and integrating family planning and reproductive health services with HIV services. In Ukraine, CDC/DRH has been involved in an intervention to prevent HIV infection and unintended pregnancies among street and out-of-school youth.
Breastfeeding, Antiretrovirals, and Nutrition (BAN) Study
The Breastfeeding, Antiretrovirals, and Nutrition (BAN) Study was a randomized-controlled clinical trial in Malawi to evaluate the following objectives: 1) the benefit and safety of antiretroviral prophylaxis given either to infants or to their mothers to prevent HIV transmission during breastfeeding, 2) the benefit of nutritional supplementation given to women during breastfeeding to prevent maternal depletion, and 3) the feasibility of exclusive breastfeeding followed by early, rapid breastfeeding cessation. Both the infant nevirapine arm and the maternal prophylaxis arm were effective and safe methods for preventing HIV transmission through breast milk. Additionally, women on the nutritional supplement lost significantly less weight than the no-supplement group.
CDC/DRH is also conducting the Accessing Counseling Message Effectiveness (ACME) Study. The ACME Study began in March 2011, and aims to develop effective counseling to help women avoid unprotected sexual activity while being treated for a sexually transmitted disease (STD) and potentially help curb STD transmission.
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