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Contraception options for people with HIV

Even if you have HIV, you can get pregnant and have a healthy baby that doesn’t have HIV. But if you don’t want to have a baby, there are lots of different types of contraception options (also known as family planning and birth control) to choose from.  

If you have HIV you need to be aware of a few things when choosing, as some contraceptives can react to HIV treatment.  

If you are taking your HIV treatment every day and your viral load is undetectable, you cannot pass on HIV to a partner who does not have HIV. But you may still need to use a condom to prevent sexually transmitted infections (STIs).  

What contraception can I use if I have HIV?

Condoms 

Anyone can use condoms, whether you have HIV or not. And they are very effective! They are the only type of contraceptive to prevent STIs, HIV and pregnancy, so they are worth trying.  

Hormonal contraception 

Some HIV treatment can make hormonal contraception less effective. But it really depends on the type of HIV treatment you are on – speak to a healthcare professional about these types of contraceptives: 

They will talk you through your options and which ones will work with your specific HIV treatment. 

Other types of contraception:  

The IUD (intrauterine device – also known as the ‘copper coil’ or ‘the coil’): this is not affected by HIV treatment.  

Pulling out: this is unreliable. If you have a detectable viral load you could pass HIV on, and you and your partner are also at risk of STIs. 

Emergency contraception: some types of HIV treatment can make emergency contraception less effective, so if you want to take this speak to your healthcare provider. 

What now?

So now you know your options. The next step is to talk to a healthcare professional. You might want to discuss your thoughts with your partner as well. 

A healthcare professional can monitor you for signs of drug interactions. You should also tell them about any other type of medication you’re taking, including herbal remedies, in case they affect your contraception. 

If there are any problems, your doctor may be able to change your HIV treatment so you can keep using the contraceptive you want. 

What if my partner also has HIV?

There are different strains of HIV. It is important to be aware that you could pass on a strain of HIV that is resistant to the type of HIV treatment that your partner is taking, or they could pass a different strain to you. 

The best way to keep each other safe is for both of you to take your HIV treatment every day so your HIV is undetectable – this means you can’t pass HIV on. 

And remember – you may still want to use a condom to prevent STIs – even if you’re using another type of contraception. 

Should we use condoms even if we are using another type of contraception?

This is up to you. Remember that condoms are the only type of contraception that stops people getting or passing on STIs.  

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Why don’t some contraceptives work if I am on HIV treatment?

This is because antiretrovirals (ARVs), which is the type of medication someone takes when they have HIV, are processed in the liver and so are hormonal contraceptives. And some ARVs can interact with hormonal contraceptives in the liver in a way that makes it process the contraceptive faster than normal. When this happens, the amount of contraceptive hormone left in the body can end up being too low to always prevent pregnancy, making it less effective. 

Does it work the other way around – can contraceptives stop my HIV treatment from working?

No. Antiretrovirals will continue to work well, no matter what type of contraception someone is using.  

How can I support someone with HIV who wants to use contraception?

If someone with HIV is thinking about using contraception, the best thing you can do is to give them clear and accurate information, which you can find above.  

The best way to speak to someone about any form of contraception is to: 

Respect their decisions: this means their decision to have sex and the type of contraceptive they choose.  

Be open: be prepared to discuss any form of contraception and let them know they can ask anything they want; you won’t judge them. 

Respect their privacy: they might feel embarrassed about discussing sex with you. If they are, connect them with a friendly healthcare professional, a helpline, or factual online resources, like this site. 

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