HIV-infected women in ART programmes

The Comment outlines several compelling reasons for promoting effective contraception among women infected with HIV. Although these concerns are appreciated, this strictly preventive approach to reproduction focuses only on reasons why infected women should not have children, overlooking the important role that fertility has in women's lives, individual and social, especially in many parts of sub-Saharan Africa.2 There is growing evidence that despite stigmatisation by health-care providers, childbearing is an important feature of life for many women infected with HIV.3 In some settings, an infected woman's decision not to have children can exacerbate HIV-related stigma and discrimination. Although there are few insights into how the availability of ART might affect the fertility intentions of HIV-infected women in the developing world, a substantial proportion of women who receive ART will probably want to consider having children.