Contraception lets you avoid pregnancy or plan a pregnancy when you’re ready to have a child. There is a wide range of methods to choose from, each with their own advantages and disadvantages. Before choosing a method of contraception it is important to discuss all options with your doctor, with particular attention to the way contraception may aggravate issues associated with your HIV infection, and ways your HIV infection and any antiretroviral treatments you are taking may undermine the effectiveness of contraception.
A number of agencies have produced great resources about contraception:
The most common form of hormonal contraception is the Pill. It is estimated to be more than 99% effective in preventing pregnancy, although this may be decreased if you take certain other medication or if you experience vomiting or diarrhoea. Some other medications, including some antibiotics, can make the Pill less effective.
Drugs in several HIV antiretroviral treatments may make some brands of the Pill less effective. Generally, women taking antiretroviral treatment that interacts with the Pill should avoid ‘low dose’ Pill formulations. If you want to use the Pill, it is important to discuss the interaction of antiviral therapies with different formulations of the Pill to find a combination that works for you. Find out more about the Pill from Family Planning NSW’s Combined Oral Contraceptive Pill factsheet.
Depo-Provera is a contraceptive injection that lasts for approximately 12 weeks. Depo-Provera is not affected by antiretroviral treatments except for the drug Atazanavir. To find out more about Depo-Provera, see Family Planning NSW’s Contraceptive Injection factsheet.
Implanon is a small rod inserted under the skin of the upper arm (about the size of a match) that slowly releases the contraceptive hormone. The device is very effective. It provides protection for three years but is readily reversible if pregnancy is desired or if you have side-effects. Implanon effectiveness is impacted by many antiretroviral treatments so ask your doctor to consider all possible drug interactions. To find out more about Implanon, see Family Planning NSW’s Contraceptive Implant factsheet.
IUD (intra-uterine device)
An IUD is a small T-shaped contraceptive device made from plastic and copper that fits inside the womb (uterus). It is also sometimes called a coil. An IUD releases copper into the body causing changes that prevent sperm from fertilising eggs. It is a highly effective contraceptive and is not affected by antiretroviral treatments. An IUD needs to be fitted by a doctor or nurse. To find out more, see Family Planning NSW’s Copper IUD factsheet.
The Mirena (Intrauterine system)
The Mirena is a small plastic device fitted in the womb. It contains hormones that reduce the risk of heavy periods (sometimes stopping them altogether) and is also used by women with heavy, painful periods as an alternative to hysterectomy. It is highly effective as a contraceptive device and is not affected by antiretroviral treatments. However, it is not recommended for women with a history of pelvic inflammatory disease. A Mirena must be fitted by a doctor or nurse but once fitted, works for five years. For more detailed information see Family Planning NSW’s Mirena factsheet.