Contraception in HIV-positive female adolescents

Abstract

Sexual behavior of HIV-positive youths, whether infected perinatally, through risky behavior or other ways, is not substantially different from that of HIV-uninfected peers. Because of highly active antiretroviral therapy, increasing number of children, infected perinatally, are surviving into adolescence and are becoming sexually active and need reproductive health services. The objective of this article is to review the methods of contraception appropriate for HIV-positive adolescents with a special focus on hormonal contraceptives. Delaying the start of sexual life and the use of two methods thereafter, one of which is the male condom and the other a highly effective contraceptive method such as hormonal contraception or an intrauterine device, is currently the most effective option for those who desire simultaneous protection from both pregnancy and sexually transmitted diseases. Health care providers should be aware of the possible pharmacokinetic interactions between hormonal contraception and antiretrovirals. There is an urgent need for more information regarding metabolic outcomes of hormonal contraceptives, especially the effect of injectable progestins on bone metabolism, in HIV-positive adolescent girls.

Women living with HIV still lack highly effective contraception: results from the ANRS VESPA2 study, France, 2011

“…However, among SSA women, the rates of contraceptive use are high compared to the observed rates in their country of birth [23], suggesting a rapid acculturation after migration to local contraception patterns. Consistent with previous studies across a range of countries [24][25][26][27][28], the distribution of contraceptive methods differs markedly among HIV-positive women compared to the general population, with a large predominance of condom use among HIV-positive women and a very low rate of use of highly effective methods, including either oral hormonal contraception or the IUD. The proportion of women reporting both HEC and condom as a contraception method was small and in the same range as reported in other western countries: 8.8% in the VESPA2 study, 12% in a convenience sample of European women [12] and 16% of adolescent and young HIV-positive women in the United States [29].…”

Cervical and systemic concentrations of long acting hormonal contraceptive (LARC) progestins depend on delivery method: Implications for the study of HIV transmission

“…Furthermore, epidemiological studies have also noted increased HIV transmission rates among high risk women who use DMPA [5, 49–51] [8]. Cessation of DMPA use in high risk women without substituting alternative effective contraceptive options could increase unwanted pregnancy rates as well as mother-to-infant HIV transmission should a woman become infected [52–54]. The public health community cannot afford to continue to promote contraceptive options, such as nonoxynol-9 [55] and DMPA, that place undue risk on vulnerable populations.…”

Pengaruh Relaksasi Otot Progresif Terhadap Kecemasan Pada Wanita Pasangan Usia Subur (Wpus) Penderita Hiv/Aids

“…WPUS, memiliki risiko yang tinggi untuk terinfeksi HIV. Berdasarkan hasil penelitian, penyebab terjadinya peningkatan kasus pada WUS adalah dikarenakan hubungan seksual dini, pasangan lebih dari satu dan tidak mengetahui status kesehatan pasangannya yang terinfeksi [4] . Penelitian Oktaseli (2017) menyebutkan bahwa wanita pasangan usia subur (WPUS) dengan HIV/AIDS menjadi semakin rumit dan rentan untuk merasa cemas serta minder jika berbaur dengan orang disekitarnya, bahkan mereka merasa takut ketika bertemu dengan orang baru dan lebih cenderung mengurung diri dengan keadaan yang dideritanya [5] .…”