HIV and reproductive health: a South African experience.

Acquired immune deficiency syndrome (AIDS), caused by the human immunodeficiency virus (HIV), disproportionately affects Africa whereby the majority of new infections and deaths occur in sub-Saharan Africa. It is the leading cause of death in Africa and a major cause of maternal mortality. HIV/AIDS impacts on every aspect of reproductive health and presents considerable challenges to healthcare systems. Fertility is particularly valued in Africa and voluntary childlessness is unusual. AIDS results in a reduction in both fecundity and fertility, as well as compromising the outcome of pregnancy. The stigma of childlessness is quite profound and impacts both social life and social standing within the community, particularly of the women who are affected. Unfortunately, treatment for infertility is often inadequate and, because of limited resources, is frequently denied to HIV-positive couples. Undoubtedly the challenges in dealing with the HIV/AIDS pandemic in Africa are enormous; however, appropriate solutions are available and these need to be put in place. It is essential that the management of the HIV patient is holistic and takes all needs, including that of fertility, into account.