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 Lira.
Yes you can use the Depo when you’re on ARV’s this isn’t an issue.
Hi i want to find out can i get depo while I’m on ARVs?
Hi Thando,
There is a risk that there could be a potential interaction between the efavirenz and the ginette. Please see here: https://www.hiv-druginteractions.org/checker Are you able to change to another ARV combination.
Hi
i am taking atroiza and ginette 35 pills because of in balance hormones that is creating acne, do you think it can affect me?
Hi Themby, There are two hormones in Evra patches which prevent unplanned pregnancy. But there is a potential for the main drug in Atroiza (efavirenz) to reduce the effectiveness of one of the hormones (norelgestromin). Can you ask your doctor to change your ARVs? There are some ARVs that don’t have the potential effect on Evra. Dolutegravir is one of these ARVs. You can ask your doctor if this is available where you live.
Hi i am on atroiza arvs.I am condomising and also uses evra patches to prevent unplanned pregnancy incase the condom burst.please advice if evra patches are ok or is there any other best contraveptive that works fine with atroiza? Thanks
Hi Lorraine,
If you aren’t using any form of birth control, then yes you could fall pregnant You being on ARVs won’t have any impact on this.
Am on arv’s and have stopped depo prevention bcoz of irregular periods will I fall pregnant?
Hi Judith
Please ask your doctor about this. I think you are asking about the implant that works as a contraceptive.
The answer depends on the type of inplant and the ARVs in your conbination.
With some HIV meds implants are less effective. They still work a bit but you need to ask your doctor about this.
what about the one on ur arm as a family planning, is it good when u r on ARVs?