BACKGROUND: Uganda has one of the highest total fertility rates (TFR) worldwide.We compared the effects of antiretroviral (ARV) prophylaxis for the prevention of mother-to-child HIV transmission (PMTCT) to that of existing family planning (FP) use and estimated the burden of pediatric HIV disease due to unwanted fertility.METHODOLOGY/PRINCIPAL FINDINGS: Using the demographic software Spectrum, a baseline mathematical projection to estimate the current pediatric HIV burden in Uganda was compared to three hypothetical projections: 1) without ARV-PMTCT (to estimate the effect of ARV-PMTCT), 2) without contraception (effect of existing FP use), 3) without unwanted sheepshead bay boats fertility (effect of unmet FP needs).Key input parameters included HIV prevalence, ARV-PMTCT uptake, MTCT probabilities, and TFR.
We estimate that in 2007, an estimated 25,000 vertical infections and 17,000 pediatric AIDS deaths occurred (baseline projection).Existing ARV-PMTCT likely averted 8.1% of infections and 8.5% of deaths.
FP use likely averted 19.7% of infections and 13.1% of deaths.Unwanted fertility accounted for 21.
3% of infections and 13.4% of deaths.During 2008-2012, an estimated 131,000 vertical infections and 71,000 pediatric AIDS deaths will occur.The projected scale up of ARV-PMTCT (from 39%-57%) may avert 18.
1% of infections and 24.5% of deaths.Projected FP use may avert 21.6% of infections and 18.
5% of deaths.Unwanted fertility will account for 24.5% of infections and underwater treasures sunken medallion 19.8% of deaths.
CONCLUSIONS: Existing FP use contributes as much or more than ARV-PMTCT in mitigating pediatric HIV in Uganda.Expanding FP services can substantially contribute towards PMTCT.