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Contraception

Both male and female condoms (Femidoms) are highly effective at preventing pregnancy, the transmission of HIV and most sexually transmitted infections. However, they need to be used properly in order for them to be effective. If you are not sure how to use them, you can ask for help from your healthcare team. You can also get help from a range of community-based organisations; for example, you may be able to attend one of the sexual health and relationship workshops run by the organisation Positively UK to get more information and support around this topic.

In the UK, HIV treatment centres and sexual health (GUM) clinics offer both male and female condoms free of charge. 

If a condom breaks during sex, the emergency contraceptive pill is available to buy from chemists. You may also be able to obtain free emergency contraception from a GP, GUM clinic or the accident and emergency department (A&E) of your local hospital. It’s important you let the doctor or pharmacist know if you are on HIV treatment, as some anti-HIV drugs interfere with the way the emergency contraceptive pill works, and you will need to take twice the normal dose. You need to take the pill within 72 hours of having sex, ideally sooner.

Having an IUD fitted stops sperm from reaching an egg and fertilising it. It is the most effective method of emergency contraception and prevents up to 99% of pregnancies. It is suitable for women with HIV 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 passing on HIV or other sexually transmitted infections.

If your partner is HIV-negative and a condom breaks during sex, they should visit a GUM clinic or A&E department as soon as possible, and definitely within 72 hours, where they may be prescribed post-exposure prophylaxis (PEP), a short course of anti-HIV drugs which may be able to prevent them from becoming infected.

Because of the need for condoms to be used properly every time to prevent pregnancy, you may want to use a back-up form of contraception as well.

Several anti-HIV drugs and antibiotics interfere with the way some hormonal contraceptives work, and the contraceptive may not be as effective as usual. Getting advice on possible drug interactions from your doctor or pharmacist is important.

These hormonal contraceptives are 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 like a sticky plaster that is changed once a week
  • implants – a small flexible rod that is inserted under the skin on the upper part of the arm, and works for up to three years
  • vaginal rings – a small flexible ring that is inserted in the vagina for three weeks of the month.

Several types of contraceptives are not affected by anti-HIV drugs. They are the intrauterine device (IUD), the Mirena intrauterine system (IUS) and the Depo-Provera injection.

An IUD is a small, T-shaped contraceptive device made from plastic and copper that fits inside the womb (uterus), sometimes called a coil. It releases copper into the body, causing changes that prevent sperm from fertilising eggs. You will be offered a sexual health screen, and any sexually transmitted infection (STI) will be treated before the coil is fitted by a doctor or nurse. It can be easily removed if it doesn't suit you.

The Mirena IUS is a small plastic device also fitted in the womb, which contains hormones that reduce the risk of heavy periods (sometimes stopping them altogether). It is also used by women with heavy, painful periods as an alternative to hysterectomy. It must be fitted by a doctor or nurse, after a sexual health check and treatment of any STI. Once it’s fitted, it works for five years.

The most common type of contraceptive injection is called Depo-Provera; it contains the hormone progestogen and each injection lasts for 12 weeks.

None of these methods prevent the transmission of HIV or other STIs.

A number of other medications (e.g. antibiotics) interact with hormonal contraceptives, so getting advice on drug interactions from your HIV doctor or pharmacist is important. During the period you are taking any antibiotics, and for a week after, you are recommended to use an additional form of contraception if you are using a hormonal contraceptive.

Diaphragms and caps are flexible rubber or silicone dome-shaped devices which are placed in the vagina each time you have sex. They are not recommended for women with HIV, as they should be used with a substance called a spermicide that can irritate the vagina.

The National Health Service (NHS) provides free access to contraception; that is, you do not need to pay a prescription charge. Contraception is available from general practitioners (GPs), and from sexual health or contraception clinics. Details of local clinics are available from NHS Direct (tel 0845 46 47 or at www.nhs.uk) or from the FPA (www.fpa.org.uk/helpandadvice/findaclinic).

HIV & women

Published November 2010

Last reviewed November 2010

Next review December 2013

Contact NAM to find out more about the scientific research and information used to produce this booklet.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.