Takeaway
- The World Health Organization (WHO) has endorsed use of all forms of reversible contraception (progestogen-only injectables, implants, intrauterine devices [IUDs], combined hormonal contraceptives) among women at high risk for HIV.
- Data suggest no increased risk for HIV acquisition.
Why this matters
- HIV risk is not a contraceptive-limiting factor.
- Offer progestogen-only methods, copper-bearing IUDs, combined contraceptives, ensure full access to family-planning services.
- Note that consideration of IUDs should also include risk for other sexually transmitted infections (STIs); refer to selected practice recommendations for contraceptive use prior to insertion.
- Include regular HIV/STI screening/testing/prevention education during routine visits as part of high-quality family-planning services.
Key points
- Data are derived from the Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial in 7829 HIV-seronegative, at-risk women, ages 16-35 years, randomly assigned to DMPA-IM, levonorgestrel implants, copper-bearing IUDs.
- There was no statistically significant association between hormonal dose, delivery, and/or progestogen type and HIV acquisition.
- While the guidance is primarily directed toward women residing in developing countries, the findings are applicable to a broad group of women at risk for HIV.
- Efforts to expand contraceptive method options/ensure full and equitable access to family planning are important.
- Ensure that at-risk women understand that hormonal contraception or IUDs are not protective against HIV/STI acquisition.
References
References
