Contraception in the Context of HIV/AIDS: A Review
Abstract
Over 50% of the 33.3 million HIV-positive persons are women within the reproductive age group. With increasing availability and use of highly active antiretroviral therapy (HAART), the prognosis, life expectancy and quality of life of infected persons has improved. HIV-positive women, like their uninfected counterparts, may desire to plan pregnancies, limit their families, or avoid pregnancy. The effective use of contraception by HIV-positive clients can contribute significantly to reduction in both sexual and vertical transmission of the virus. HIV-positive clients can use most of the available contraception methods including barrier, hormonal, intrauterine devices and sterilization. However, some antiretroviral drugs interact with hormonal contraceptives with potentials for reduction in efficacy. Dual protection with concomitant use of a more effective contraceptive method and male or female condom to prevent HIV and Sexually transmitted infections (STIs) is the standard. It is necessary to make provision for contraceptive service as part of comprehensive care for the HIV-positive client (Afr J Reprod Health 2011; 15[3]:15-23).
Résumé
Contraception dans le contexte du VIH/SIDA: Plus de 50% des 33.5 millions des gens séropositives sont des femmes qui sont encore en âge de procréer. Grace à la disponibilité croissante et de l’emploi de la thérapie antirétrovirale active élevée(TAAE), la pronostic, l’espérance de vie et la qualité de vie des gens atteints s’est améliorée. Les femmes séropositives, comme leurs homologues non atteints, peuvent désirer planifier des grossesses, limiter le nombre d’enfants ou éviter la grossesse. L’emploi efficace de la contraception par les clientes séropositives peut contribuer de manière significative à la réduction dans la transmission verticale du virus. Les clientes peuvent se profiter des méthodes de la contraception disponible y compris la barrière, l’hormonal, les dispositifs utérins et la stérilisation. Néanmoins, certains médicaments antirétroviraux réagissent avec des hormono-contraceptifs qui ont la capacité de réduire l’efficacité. La double protection avec l’usage concomitant d’une méthode contraceptive plus efficace ainsi que le préservatif pour homme ou pour femme pour prévenir le VIH et les maladies sexuellement transmissibles(MST) demeure la norme. Il faut prévoir un service contraceptif comme faisant partie des soins compréhensif pour les clientes séropositives (Afr J Reprod Health 2011; 15[3]:15-23).
Keywords: AIDS, HIV, contraception, family planning, highly active antiretroviral therapy (HAART), condom
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