High levels of HIV prevalence among women of childbearing age in many parts of the world carry a triple tragedy. Not only do HIV-positive women face the prospect of discrimination, illness and early death, but they may also pass the HIV infection to their children or leave their children behind as orphans when they die. Efforts are underway to rapidly expand programs to prevent adult HIV infections (through behavior change communications programs, voluntary counseling and testing and other prevention programs) and to improve treatment for those already infected. Programs are also focusing on expanding access to services to prevent the transmission of HIV from mother to child (PMTCT). These programs offer the promise of preventing thousands of new infections and child deaths. The addition of family planning to these services could save even a greater number of lives.

This analysis looks at the costs and benefits of adding family planning services to programs for the prevention of mother to child transmission of HIV in fourteen high HIV prevalence countries. The benefits of PMTCT programs are substantial. They are further enhanced by the addition of family planning services which by 2007 could avert an additional 55,000 child deaths, save 7,000 women’s lives through a combination of fewer births and better birth spacing and avert 155,000 potential orphans. Family planning can double the impact of PMTCT programs in reducing HIV+ births and can have an even larger impact on reducing child and maternal deaths. The cost of adding family planning to PMTCT services is only about $360 per child death averted.