Special Considerations

Women living with HIV
Women with HIV/AIDS who are treated with ritonavir-boosted protease inhibitors, a class of ARV drugs, generally should not use combined hormonal methods or progestin-only pills. These ARV drugs may make these contraceptive methods less effective. These women can use progestin-only injectables, implants, and other methods. Women not taking ARVs or taking only other classes of ARVs can use any hormonal method.

Women who have Tuberculosis
Women on rifampicin or rifabutin for tuberculosis should also be aware that these drugs decrease the effectiveness of oral contraceptive pills, contraceptive ring or patch. Barrier methods, Injectable contraceptives or implants are appropriate alternatives.

Dual Contraceptive Methods
The use of two contraceptive methods, usually a hormonal method and condom use has been shown to be more effective for preventing pregnancy and also prevents Sexually Transmitted Diseases.

Emergency Contraceptives: Key Points

  1. Emergency contraceptive pills help to prevent pregnancy when taken up to 5 days after unprotected sex.
  2. They are more effective when taken earlier after the act of sexual activity.
  3. They do not cause harm to the unborn foetus if taken by a woman who is already pregnant.
  4. They are safe for use in all women, even women who cannot use ongoing hormonal contraceptive methods.
  5. They should be used to prevent pregnancy in women who have been subjected to forced sexual intercourse (rape).
  6. They should not be used on an ongoing basis to prevent pregnancy.
  7. After using Emergency Contraceptives, women who are sexually active should consider starting an ongoing family planning method.
  8. Many options can be used as emergency contraceptive pills. Dedicated products, progestin-only pills, and combined oral contraceptives as well as an IUD inserted within 5 days of sexual intercourse can all act as emergency contraceptives.

Sero-Discordant Couples
Sero-Discordant Couples are couples in which one partner is HIV infected and the other is HIV negative. These couples may wish to have child(ren). Their options include:

  • Adoption/ fostering children
  • Surrogacy
  • Limiting unprotected intercourse to the most fertile period in the female’s cycle when the viral load of the infected partner is undetectable.

Talk with your health care provider about reducing risk to the uninfected partner while trying to become pregnant.

For more information on each of these contraceptive options, visit the links below:

https://www.fphandbook.org/sites/default/files/wallchart_english_2012.pdf

http://www.jnfpb.org/

For a comparison of the efficacy of different methods, visit the link below:

http://www.cdc.gov/reproductivehealth/UnintendedPregnancy/PDF/Family-Planning-Methods-2014.pdf

                                          

Visit your nearest health centre or your health care provider and discuss which method is right for you.

You may also contact the National Family Planning Board:

http://www.jnfpb.org/poster%20marge%20roper.jpg

References

  1. https://www.fphandbook.org/sites/default/files/wallchart_english_2012.pdf. Accessed January 18, 2015 at 12:15 pm
  2. http://whqlibdoc.who.int/publications/2011/9780978856373_eng.pdf. Accessed January 18, 2015 at 12:15 pm
  3. http://www.cdc.gov/reproductivehealth/UnintendedPregnancy/PDF/Family-Planning-Methods-2014.pdf. Accessed January 18, 2015 at 12:15 pm
  4. http://www.who.int/topics/family_planning/en/. Accessed January 18, 2015 at 12:15 pm
  5. http://www.jnfpb.org/. Accessed January 18, 2015 at 12:15 pm