Question
Besides condoms, what other contraception can I use?
15 March 2012. Related: All topics, Sexual health.
I am a 40 year old female who has been positive for 4 years. Presently, I am on combination drugs.
Besides condoms, what is the best form of short-term contraception?
Answer
Thank you for your question.
As there are a number of options available in response to your question, my answer is going to be quite lengthy. I hope you don’t mind.
Besides male and female condoms, there are a number of short term contraceptive options available for women taking ARVs(Antiretroviral treatments for HIV). Some hormonal contraceptives such as the oral contraceptive pill, patch and implants may not be as effective if you are taking ARVs. This is because some ARVs reduce their effectiveness.
The following options are recommended by the The BHIVA (British HIV Association) guidelines for the management of the sexual health of people living with HIV.
The first option is the Depo contraceptive injection. This is an extremely effective method of contraception for women taking ARVs or using drugs to treat TB. It is given as an injection every 12 weeks and therefore you can link this with your clinic visits.
You did not specify ARVs you are taking. However, as HIV infection itself and some ARVs have been linked to reduced bone thickness, it may not be the best choice for teenagers with growing bones, or older women who may start to lose bone thickness. If, after discussion you choose to go ahead with this method, then your doctor can perform a test which measures bone thickness prior to starting, if you have concerns about this. The important thing to note is that it may take upto a year for fertility to return after stopping Depo.
The second option is the Mirena coil which is a hormone releasing system that can be used by both women who are taking or not taking ARVs. The coil is inserted into the uterus and in the clinic setting and can remain for upto 5 years. It is an extremely effective form of contraception and can be removed when you are planning pregnancy.
The third option are other IUDs (Intrauterine devices), or coils, which do not release hormones and are also safe and effective methods of contraception for women living with HIV regardless of whether they are taking ARVs or not. IUDs are effective for 3-10 years depending on the type. A full sexual infection screen should be performed before both the Mirena or to IUDs can be inserted.
Finally, if you haven’t started using contraception and have an ‘accident’, then you have the option to use EC (emergency contraception).The two main methods available are: ‘the morning after’ pill which must be taken within 72 hours of the unprotected sex. For women on ARVS, the recommendation it to take a double dose of 3mg; or the insertion of a copper IUD up to 5 days after sex. This is the preferred option for women taking ARVs as this method is not affected by other drugs.
Best wishes.
Hi Poppy,
Thanks for this question. Luvigen pills contain three drugs. These pills are also know as TLD. And they contain Tenofovir DF, Lamividune (3TC) and Dolutegravir. Some ARVs can interact with some contraceptives. But TLD is likely to be fine with your choice of contraception.
So it’s a good idea to talk to your doctor. You can ask about contraception that suits you as an individual. You can choose contraception that goes well with you and your needs.
Here’s a link to the HIV drugs interaction website and the contraceptives chart.
Hi I’m 46 years old,and I’m taking LUVIGEN pills medication that I take only in the morning for HIV, what I want to know is what contraceptive can I use for birth control,my name is Poppy
Hi Mpho,
What ARVs are you taking?
Im 41 years old and im on combination of Arvs can i use the pill for birthcontrol because injections makes me bleed a lot if i use it.the only thing that treats me well is birth control pill.if yes wich ones are best.i was using nodette when i was stilll negative im not sure if they are recomended now that i am living with hiv.
Hi Winnet,
Unfortunately we are not doctors at i-Base. But we do give information about HIV treatment to people who are HIV positive. So it’s a good idea to talk to your doctor about this and find out what the problem is.
You can try to get help from the fertility clinic too. They could try and work with your HIV doctor to help you conceive.
I am on combivir and efavirenz since 2010, am now having problems with my cycle since March 2017 , I was on loop (IUD) n had it removed last yr July. Since then am no longer regular on my cycle, I skip 3 months at times 2 months. Am currently not on contraceptives n want to conceive. What could be the problem. Am 36yrs of age, plz help.