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Pregnancy and conception
The positive impact which anti-HIV therapy has had on the health of many people with HIV, and the availability of effective means of reducing the rate of mother-to-child HIV transmission, may have encouraged some HIV-positive women to reconsider decisions about sex and relationships, and about having children. If you would like support thinking through these issues, it may be helpful to see a counsellor, or to talk to other HIV-positive women. One option is Positively Women, a national organisation providing peer support to HIV-positive women and their children (tel 020 7713 0222). Another option is Body and Soul, a self-help organisation which supports women, heterosexual men, children and families living with or affected by HIV (tel 020 7383 7678).
In the UK, HIV treatment centres and sexually transmitted infections (GUM) clinics offer condoms free of charge. 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 Family Planning Clinics. Details of local Family Planning Clinics are available from NHS Direct on 0845 46 47.
You cannot join a clinical trial looking at the effectiveness of new HIV drugs if you are pregnant or thinking of becoming pregnant. See the booklet, Clinical Trials in this series for more information.
If you are planning pregnancy (or are pregnant) it's very important that you tell your doctor so they can, with you, reduce the risk of your baby being infected with HIV and ensure your drugs are the best ones for pregnancy.
Contraceptive choices need to be made on an individual basis. Although condoms are highly effective at preventing both pregnancy and the transmission of HIV and most sexually transmitted infections, they have to be used properly to work. You may therefore wish to consider a back-up form of contraception, in addition to condoms. Of the alternatives:
- The Mirena Coil includes hormones that reduce the risk of heavy periods and anaemia. Before the coil is fitted, you will be offered a sexual health screen and be given treatment with antibiotics if you have an infection. It can be easily removed if it doesn't suit you.
- Protease inhibitors reduce blood levels of the oestrogen component in oral contraceptive pills, so women taking both the Pill and protease inhibitors may need to use back-up methods of contraception.
- A number of other medications, e.g. ampicillin, may interact with oral contraceptives, so getting advice on drug interactions from your HIV doctor or pharmacist is important.
During the period you are taking antibiotics, and for a week after, you are recommended to use an additional form of contraception.