6 February 2018

Women living with HIV in Switzerland are mainly relying on male condoms for contraception, investigators report in HIV Medicine. The study found that two-thirds of reproductive age women reported using contraception, with three-quarters of these individuals putting their trust in male condoms. Unwanted pregnancies were not uncommon among women using contraception.

“Male condoms remained the most frequently used contraceptive method, whereas the use of long-acting reversible contraceptives was very uncommon,” note the researchers. “One in six women using contraceptives experienced an unwanted pregnancy, with 42% occurring while using a combined hormonal pill.”

Because little is known about contraceptive use by women living with HIV in Europe, investigators from the Swiss HIV Cohort Study designed a cross-sectional study involving 462 women. The participants were all of reproductive age and completed questionnaires about their use of contraception, relationship status and unwanted pregnancy. Results found that women living with HIV faced potential barriers to obtaining effective contraception. The investigators suggest that HIV clinicians need to do more to encourage effective contraceptive use by women with HIV, especially in the light of growing awareness that people with HIV with undetectable viral load do not transmit HIV. If couples stop using the male condom, women need information about which contraceptive options are suitable for them.

“In Switzerland, contraceptive counselling is partially integrated in HIV care, but women have to be referred to a gynaecologist for the prescription of hormonal and long-acting contraceptives, such as IUDs and injectablables,” comment the authors. “This may result in reduced access to effective contraception as women do not always engage in routine gynaecological care or they are lost to follow-up for some time, especially after having a baby.”

Overall, 36% of women reported not using contraception, and 40% of these individuals reported being sexually active. Almost half (44%) of these sexually active women said they did not want to conceive. The use of effective contraception is challenging in women of reproductive age living with HIV. HIV care physicians should be attentive both to women’s choices and to their needs for contraception,conclude the authors.

Read the full article online here.