Meeting the Reproductive Health Needs of Female Key Populations Affected by HIV in Low- and Middle-Income Countries: A Review of the Evidence

Stud Fam Plann. 2017 Jun;48(2):121-151. doi: 10.1111/sifp.12020. Epub 2017 Apr 19.


Female sex workers and other women at high risk of acquiring HIV have the right to sexual and reproductive health, including the right to determine the number and timing of pregnancies. We conducted a literature review to examine the data that exist regarding the family planning and reproductive health needs of female key populations, the underlying determinants of these populations' vulnerability to poor reproductive health outcomes, and the obstacles they face in accessing high-quality reproductive health services. Findings indicate that female key populations experience high rates of unmet need for family planning and safer conception services, unintended pregnancies, sexual violence, and abortion, and that they practice inconsistent condom use. Restrictive policy environments, stigma and discrimination in health care settings, gender inequality, and economic marginalization restrict access to services and undermine the ability to safely achieve reproductive intentions. We offer recommendations for structural, health system, community, and individual-level interventions that can mitigate the effects of these barriers and improve reproductive health outcomes.

Publication types

  • Review
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Abortion, Induced / statistics & numerical data
  • Age Factors
  • Contraception Behavior / statistics & numerical data
  • Developing Countries*
  • Family Planning Services / organization & administration
  • Female
  • HIV Infections / prevention & control
  • HIV Infections / therapy
  • Health Services Accessibility / economics
  • Health Services Accessibility / organization & administration*
  • Humans
  • Intimate Partner Violence / prevention & control
  • Needs Assessment
  • Pregnancy
  • Pregnancy, Unplanned
  • Reproductive Health Services / economics
  • Reproductive Health Services / organization & administration*
  • Reproductive Health Services / standards
  • Sex Workers / statistics & numerical data
  • Substance Abuse, Intravenous / epidemiology
  • Transgender Persons / statistics & numerical data
  • Vulnerable Populations*

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