Gynaecological and Reproductive Health Issues in HIV-Positive Women

BACKGROUND: Women constitute over 60 percent of the HIVinfected population in sub-saharan Africa. Highly active antiretroviral therapy (HAART) has improved the life span of people living with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). Advances in scientific knowledge and management of the HIV-positive pregnant woman have also led to reduction in the risk of motherto- child transmission (MTCT) of HIV. The gynaecological and reproductive health needs and care of the HIV-positive woman are poorly appreciated, suboptimal and largely neglected, with potential to negatively affect their quality of life and efforts at control of the HIV epidemic. OBJECTIVE: To review the contemporary gynaecological and reproductive health problems and management of the HIVpositive woman. METHODS: A review of local and international publications on gynaecology / reproductive health and HIV from indexed / online journals and relevant websites using Pubmed and Google search in the period between 1980 and March 2009. RESULTS: The HIV-positive woman suffers increased frequency and severity of pelvic infections and cervical premalignant and malignant lesions. Relapses and treatment failures of these conditions are common among these patients. Infertility and contraception are also challenges to the HIVpositive woman. Gynaecological and reproductive health care is an integral part of the comprehensive health care needs of the HIV-positive woman. CONCLUSION: In addition to antiretroviral treatment, HIVpositive women should be provided regular screening for sexually transmitted infections (STIs), cervical cytology, counselling and services for infertility and contraception. Appropriate attention to the gynaecological and reproductive health needs of the HIV-positive woman will improve her general health status and quality of life and contribute to reduction in the incidence of HIV infection.