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HIV and contraception


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Which types of contraception can I use if I have HIV?

All types of contraception (except the diaphragm and cap) are suitable for women with HIV who are not taking treatment. Some methods are less effective if you’re taking anti-HIV drugs.

Several anti-HIV drugs interfere with the way some ‘hormonal’ contraceptives work, and the contraceptive may not be as effective as normal. It’s important to talk to your doctor about this if you are taking a hormonal contraceptive, or if you would like to. For example, this is the case for:

  • The drugs efavirenz (Sustiva) and nevirapine (Viramune) in the non-nucleoside reverse transcriptase inhibitor (NNRTIs, non-nukes) class.
  • Protease inhibitors (PIs), for example Kaletra.
  • The integrase inhibitor elvitegravir (Vitekta) - also found in the combination pills Genvoya and Stribild.

Most people taking anti-HIV drugs will be taking a drug from one of these classes.

These hormonal contraceptives may be less effective if you’re taking HIV treatment:

  • the combined pill
  • the progestogen only pill, also known as the mini-pill
  • patches – a small beige patch applied to the skin and changed once a week
  • implants – a small flexible rod inserted under the skin on the upper arm, which works for up to three years
  • vaginal rings – a small flexible ring inserted in the vagina for three weeks of the month.

Why can't I use the diaphragm or the cap?

These are not recommended for women with HIV because they're generally used with spermicide which can lead to lesions, sores and irritation. These can increase the risk of passing on HIV.

These hormonal contraceptives are safe and effective for women on HIV treatment:

What types of emergency contraception are there?

There are two types of emergency contraception:

  1. Emergency contraceptive pill
  2. Intrauterine device (IUD)

1. Emergency contraceptive pill:

There are two types of emergency contraceptive pill (also known as the morning-after pill) - Levonelle and ellaOne.

Levonelle has to be taken within 72 hours (three days) of unprotected sex and ellaOne within 120 hours (five days).

Can I take the morning after pill if I'm on HIV treatment?

It’s important you let the doctor or pharmacist know if you're on HIV treatment, as some anti-HIV drugs interfere with the way the emergency contraceptive pill works.

For example, ellaOne is not suitable for women on HIV treatment because of interactions with HIV drugs.

Women on antiretroviral treatment will need to take twice the normal dose of Levonelle.

Where can I get the emergency contraceptive pill?

You can get free emergency contraception from some GP surgeries (not all provide the IUD), some sexual health clinics, some accident and emergency departments of hospitals (A&E), family planning and young people’s clinics.

The emergency contraceptive pill is also available to buy from chemists without a prescription. It costs about £30-£35, but some chemists will provide it free of charge. You can also buy a cheaper, generic version at Superdrug.

You need to take the pill within 72 hours of having sex (unless you are taking ellaOne, which has to be taken within five days). The sooner you take it, the more likely it is to work.

2. Intrauterine device (IUD):

The intrauterine device (IUD) is a small, plastic and copper device that can be fitted into your womb by a doctor or nurse within five days of having unprotected sex. You can have this done at a family planning clinic, sexual health clinic or at some GP surgeries. You will not have to pay.

The IUD stops sperm from reaching an egg and fertilising it, and can prevent a fertilised egg from implanting in the womb. It's the most effective method of emergency contraception and prevents up to 99% of pregnancies.

Can I use an IUD if I'm on HIV treatment?

The IUD is suitable for women taking HIV treatment as it doesn’t contain any hormones. You may want to continue to use it as a long-term form of contraception.

But remember that this type of contraception doesn’t prevent you from passing on HIV or other sexually transmitted infections.

Terminating a pregnancy (abortion)

There are no contraindications to having an abortion if you're HIV positive. See our abortion section for details about how the procedure is carried out and where to find help.

More information:

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The Information Standard: Certified member

This article was last reviewed on 5/7/2017 by Anna Peters

Date due for the next review: 5/7/2020

Content Author: S. Corkery (NAM)

Current Owner: G. Hughson (NAM)

More information:

Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy, Alison J. Rodger, MD; Valentina Cambiano, PhD; Tina Bruun, RN; Pietro Vernazza, MD; Simon Collins; Jan van Lunzen, PhD; Giulio Maria Corbelli; Vicente Estrada, MD; Anna Maria Geretti, MD; Apostolos Beloukas, PhD; David Asboe, FRCP; Pompeyo Viciana, MD1; Félix Gutiérrez, MD; Bonaventura Clotet, PhD; Christian Pradier, MD; Jan Gerstoft, MD; Rainer Weber, MD; Katarina Westling, MD; Gilles Wandeler, MD; Jan M. Prins, PhD; Armin Rieger, MD; Marcel Stoeckle, MD; Tim Kümmerle, PhD; Teresa Bini, MD; Adriana Ammassari, MD; Richard Gilson, MD; Ivanka Krznaric, PhD; Matti Ristola, PhD; Robert Zangerle, MD; Pia Handberg, RN; Antonio Antela, PhD; Sris Allan, FRCP; Andrew N. Phillips, PhD; Jens Lundgren, MD
Journal of the American Medical Association
JAMA. 2016;316(2):171-181. doi:10.1001/jama.2016.5148

Contraception, NAM Aidsmap, July 2014

Emergency contraception, NHS Choices, January 2015

Emergency contraception, FPA, May 2017

IUD (intrauterine device), FPA, July 2014

How risky is an abortion if I am positive?, i-Base, April 2012

Contraception, by Selina Corkery, NAM Aidsmap, March 2017

New British guidelines recommend treatment for everyone with HIV by Keith Alcorn, 24 June 2015, NAM

Fakoya A et al. UK Guidelines for the management of sexual and reproductive health of people living with HIV infection (2008) BHIVA, BASHH, FRSH

HIV drug interactions

NHS Choices: Abortion - Introduction

NHS Choices: Abortion - What to expect

FPA: Abortion

FPA: Pregnant and don't know what to do? A guide to your options

Fakoya A et al. UK Guidelines for the management of sexual and reproductive health of people living with HIV infection, (2008) BHIVA, BASHH, FRSH

NHS Choices: Emergency contraception