Meeting the Contraceptive Needs of Key Populations Affected by HIV in Asia: An Unfinished Agenda.

Like all women, women living with and at risk of acquiring HIV have the right to determine the number and timing of their pregnancies and to safely achieve their reproductive intentions. Yet, many women in Asia affected by HIV lack access to family planning services and experience disproportionately high rates of unintended pregnancy and abortion. Programs that have succeeded in promoting condom use and providing HIV prevention and treatment services in this region have largely missed the opportunity to address the contraceptive needs of the key populations they serve. The importance of better linkages between family planning and HIV policies and programs is now widely recognized by global health policymakers and donors. However, to date, most of the efforts to improve these linkages have been conducted in Africa. Greater attention is needed to the developing, implementing, and evaluating of integrated family planning/HIV approaches that are tailored to the political, cultural, and public health context in Asia. In this paper, we describe the use of and need for family planning among key populations affected by HIV in Asia, discuss the challenges to effectively addressing of these needs, and offer recommendations for strengthening the linkages between family planning and HIV policies and programs in the region.

The Mexican HIV/AIDS surveillance system: 1986-2001.

OBJECTIVE: The objective of this article is to provide a comprehensive overview of the evolution of the Mexican HIV/AIDS surveillance system between 1986 and 2001. DESIGN: All information was collected through an extensive literature search. METHODS: Databases such as the Mexican National AIDS Programmes RIMSIDA (Registry of Mexican AIDS Research), MedLINE, PopLine, and AIDSLINE were used. Databases, keywords, and MeSH headings to search were discussed and agreed upon before and during the literature search. RESULTS: Two hundred and twenty articles and conference abstracts were reviewed and showed that the Mexican surveillance system has undergone many adaptations. The HIV/AIDS surveillance system began in 1986, when the focus was on identifying AIDS cases. This period was followed by special studies among risk groups, and served as the basis for the sentinel surveillance system that was adopted in 1990. The system now requires HIV and AIDS case reporting as well as sentinel surveillance. Mexico has also carried out the piloting of the behavioural surveillance component of Second Generation Surveillance. CONCLUSION: The Mexican experience illustrates how surveillance systems need to be dynamic in order to monitor trends in HIV over time. This review also demonstrates that middle-income countries can successfully implement surveillance systems. However, although Mexico has had many successes, a need exists to address issues that limit its ability to implement AIDS case and behavioural surveillance fully and consistently.