Associations between HIV/AIDS funding activities and family planning efforts

Abstract

Thirty years since the onset of the HIV epidemic, the global community has achieved many significant milestones to combat the disease thanks to an unprecedented financial commitment for the cause. However, some argue that the disproportionately large disease-specific funding creates a parallel funding structure, which may hinder the necessary integration between different health agendas. One key issue is the lack of integration between HIV and family planning/reproductive health services. Despite the natural and substantive link, the existing literature suggests that the expansion of HIV program may be at the expense of critical family planning programs. This paper seeks to examine the claim that there may be a negative linkage between HIV/AIDS funding and family planning efforts. The author first observes the extent of family planning needs in countries with high HIV prevalence rates and finds that in ten countries worst hit by the epidemic, 1 in 4 women do not have access to contraceptives despite their desire to use contraception. The author then uses the difference-in-differences method to study the changes in Family Planning Efforts index (measured by the Futures Group) in 41 HIV-endemic countries by the amount of HIV aid received relative to each country’s Gross National Income. These analyses repeatedly suggest that countries receiving a large sum of HIV aid relative to their national economy perform worse in family planning efforts over time compared to the countries receiving smaller sums of HIV aid. This paper also includes case studies of Uganda, Zimbabwe, and Vietnam to provide qualitative dimensions and to present policy implications. This is a preliminary research connecting HIV/AIDS funding and its effect on family planning efforts. Future research is critical to comprehensively understand the linkage between the two factors and to develop effective ways for integration.