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Contraception

Contraception is a way to prevent pregnancy. This allows you to plan a pregnancy for a time when you’re ready to have a child or to avoid ever becoming pregnant. There is a wide range of methods to choose from. You can get more information on HIV and contraception, tailored to your situation, by using NAM’s online tool HIV & contraception (see www.aidsmap.com/contraception)

Condoms

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 and consistently in order for them to be effective. You can find out more about how to use both male and female condoms in NAM’s factsheet on condoms at (see www.aidsmap.com/factsheets).

You can also ask for help from your healthcare team or 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. 

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

Several anti-HIV drugs interfere with the way some hormonal contraceptives work, and the contraceptive may not be as effective as usual. You can use the HIV & contraception tool to find out if that’s the case with any anti-HIV drugs you take.

Some other medications, such as some antibiotics, can also affect hormonal contraceptives and make them less effective. It is important to let your doctor know about any other drug you are taking, including any contraceptives. Getting advice on possible drug interactions from your HIV 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 hormonal contraceptives are not affected by anti-HIV drugs. They are the intrauterine device (IUD or coil), 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.

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 and increase the chances of passing on HIV to an HIV-negative partner.

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

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 on local NHS websites or at www.nhs.uk or from the FPA (www.fpa.org.uk).

Emergency contraception

If there’s an occasion where you haven’t used any contraception or you have a contraceptive failure (for example, a condom breaks or comes off 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, as the chance of the emergency contraception working reduces with time.

Having an IUD, or coil, 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.

If your partner is HIV-negative and a condom breaks or comes off during sex, they should visit a GUM clinic or A&E department as soon as possible (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.

You can find out more about HIV, contraception and the options available to you by using NAM’s online tool HIV & contraception at www.aidsmap.com/contraception

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.