Presentation on theme: "Contraceptive Options for Women and Couples with HIV Condoms."— Presentation transcript:
Contraceptive Options for Women and Couples with HIV Condoms
Condoms Prevent both pregnancy and STIs/HIV when used consistently and correctly In real-life situations, correct and consistent use may be difficult to achieve Source: Hatcher, 2007. 21%15%typical use 5%2%perfect use Male Female Pregnancy rates:
Condoms Prevent STI/HIV Transmission Typical use: 80% reduction in HIV incidence Consistent use: infection rate less than 1% per year in discordant couples With HIV-positive partner: inconsistent condom use is as risky as using no condom at all Prevents STIs transmitted through body fluids –less effective for skin-to-skin contact STIs Source: Weller, 2002; Deschamps, 1996; Hatcher, 2007.
Sperm A contradiction? No, not really … If we say condoms are so good at stopping the tiny HIV virus, then why do we say that they are not so good at stopping sperm, which is much bigger? HIV virus No competition for stopping HIV Some very effective competition for stopping pregnancy
Condom Use by Clients with HIV Prevent STI/HIV transmission Prevent possible superinfection with a different HIV strain Are less effective in typical use than some other methods for pregnancy prevention Consistent and correct use should be encouraged WHO Eligibility Criteria ConditionCategory HIV- infected 1 AIDS1 ARV therapy 1 Source: WHO, 2004; updated 2008.
Women and Couples with HIV Should Avoid Spermicides and Diaphragms
Spermicides Provide limited protection with pregnancy rates: –18% perfect use –29% typical use Provide no STI protection May increase risk of HIV (when used several times per day) Source: Hatcher, 2007; Wilkinson, 2002; WHO, 2002; Van Damme 2002.
Diaphragms Diaphragm used with spermicide –6% failure rate in perfect use –16% failure rate in typical use May offer limited protection from STI/HIV –blocks cervix as entry point for gonorrhea, chlamydia, and HIV –studies are under way Source: Hatcher, 2007; Moench, 2001; Hu, 2000; Padian, 2007.
Spermicide and Diaphragm: Use By Women with HIV Use not recommended Spermicides alone or used with a diaphragm may increase the risk of HIV transmission If a woman desires reliable pregnancy protection, encourage consideration of other methods Encourage dual method use Source: WHO, 2004; updated 2008; Gottlieb, 2004.