A Systematic Review on the Association Between Hormonal Contraception and Antiretroviral Therapy in HIV-Positive Women

Providing women with safe and effective means of contraception is important when assessing women’s health needs. Women with HIV can spread the disease to their baby through vertical transmission but this may be curtailed by the use of antiretroviral therapy. Additionally, providing women who have HIV with safe contraception options improves women’s overall health. However, there is concern that some hormonal contraceptives may affect the metabolism with certain antiretrovirals. A literature search was conducted using the databases Medline, PubMed, and Global Health. Articles meeting the inclusion criteria were then assessed. Thirteen peer-reviewed articles were identified. Several studies indicated that there were no relevant interactions for measures of disease progression, disease transmission and tolerability. However, some articles suggested that there were safer means of contraception that should be made available to women on antiretroviral therapy. Efavirenz was shown to induce adverse contraception efficacy when co-administered. Collectively, hormonal contraception is widely safe for women using antiretroviral therapy. HIV positive women should be educated on the risks associated with hormonal contraception as well as be provided with options that fit their reproductive health needs