Infertility in African countries: challenges created by the HIV epidemic

HIV infection and infertility are two common reproductive health disorders in Africa. From the perspective of infertility-related reproductive health care, the HIV epidemic has created several challenges which include reduction of fecundity, depletion of scarce health resources, creation of barriers to infertility treatment and increased suffering. Infertility in turn is a risk factor for HIV acquisition and a possible force in the spread of the HIV epidemic. Recognition of the reproductive health needs and desires of HIV-infected infertile men and women is a prerequisite for addressing these challenges. Subsequent strategies comprise the development of treatment guidelines for low-resource environments and a greater integration of HIV and sexual and reproductive health services. Where resources for infertility treatment are not available, the consequences must be critically assessed.