HIV 7 – Contraception

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FAMILY PLANNING AND CONTRACEPTION FOR WOMEN LIVING WITH HIV

 It is recommended that women living with HIV who do not currently desire to become pregnant should be provided with a choice of contraceptive options.1d,2a
Methods of contraception include:1e

 

BARRIER METHODS block sperm from reaching an egg3a

  • Condoms (male and female)

SHORT-ACTING HORMONAL METHODS interfere with ovulation, fertilisation or implantation of a fertilised egg3b

  • Oral Contraceptives
  • Injection

LONG-ACTING REVERSIBLE HORMONAL METHODS stop ovulation, fertilisation or implantation of a fertilised egg3c

  • Intrauterine Contraceptive Devices (IUCDs)
  • Implant

EMERGENCY CONTRACEPTION can be used after unprotected sex or when another form of contraception fails3d

  • Emergency pill or IUD

STERILISATION suitable for a woman with no desire for a child now or in the future.2b

  • Sterilisation (male or female)

 

Contraceptive choices, however, are often influenced directly or indirectly by social, economic, and cultural factors.1b

 

Regardless of what method is chosen for pregnancy prevention, all women at risk or living with HIV should be strongly encouraged to use condoms consistently and correctly.2c
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PREVENTION OF PREGNANCY – A PARTNERSHIP

The health and co-operation of both partners is important for safe contraception.1e The contraceptive choice depends on if or when the woman may want to fall pregnant in the future.1f If a woman does fall pregnant, she and her partner should continue using condoms consistently during pregnancy and the breastfeeding period.1g

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THE ‘DUAL METHOD’

All women living with HIV, who wish to avoid pregnancy, should consider a dual method of effective contraception consisting of:

  •  a hormonal method or IUCD of their choice to prevent pregnancy, and
  •  a barrier method (male/female condoms) to prevent STIs and HIV transmission1d
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ADDITIONAL PROTECTION

Additional HIV preventative measures such as voluntary adult male medical circumcision, awareness of one’s HIV status and reduction in number of sexual partners can also aid in the prevention of HIV transmision from partner to partner.1j,2c For more on preventative measures read further here:  HIV 6 – Preventing HIV

 

It is important to know that no hormonal contraceptive method provides protection against acquiring STIs and HIV.  Therefore consistent and correct condom use in addition to the chosen hormonal contraceptive method to prevent pregnancy is required.2f,g
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ARE THERE ANY INTERACTIONS BETWEEN CONTRACEPTION AND HIV MEDICINES?

Generally, most forms of hormonal and long-acting reversible methods of contraception can be used by most women living with HIV.2d,e
There are some concerns that hormonal contraceptives may have reduced efficacy when combined with certain HIV medicines, e.g. if you are taking a regimen containing efavirenz, then an implant is not recommended.1h Always consult a health care professional to determine which contraceptive options is best for you and continue to use condoms correctly and consistently.1h

 

Speak to your doctor or pharmacist for further advice on your condition and the best treatment options for you.
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