Contraceptives for Clients with STIs, HIV, and AIDS

People with STIs, HIV, AIDS, or on antiretroviral (ARV) therapy can start and continue to use most contraceptive methods safely. In general, contraceptives and ARV medications do not interfere with each other. There are a few limitations, however. See the table below. (Also, every chapter on a contraceptive method provides more information and considerations for clients with HIV and AIDS, including those taking ARV medications.)

Special Family Planning Considerations for Clients with STIs, HIV, AIDS, or on Antiretroviral Therapy

Method	Has STIs	Has HIV or AIDS	On Antiretroviral (ARV) Therapy
Intrauterine device (copper-bearing or hormonal IUDs)	Do not insert an IUD in a woman who is at very high individual risk for gonorrhea and chlamydia, or who currently has gonorrhea, chlamydia, purulent cervicitis, or PID. (A current IUD user who becomes infected with gonorrhea or chlamydia or develops PID can safely continue using an IUD during and after treatment.)	A woman with HIV can have an IUD inserted. A woman with AIDS should not have an IUD inserted unless she is clinically well on ARV therapy. (A woman who develops AIDS while using an IUD can safely continue using the IUD.)	Do not insert an IUD if client is not clinically well.
Female sterilization	If client has gonorrhea, chlamydia, purulent cervicitis, or PID, delay sterilization until the condition is treated and cured.	Women who are infected with HIV, have AIDS, or are on antiretroviral therapy can safely undergo female sterilization. Special arrangements are needed to perform female sterilization on a woman with AIDS. Delay the procedure if she is currently ill with AIDS-related illness.
Vasectomy	If client has scrotal skin infection, active STI, swollen, tender tip of penis, sperm ducts, or testicles, delay sterilization until the condition is treated and cured.	Men who are infected with HIV, have AIDS, or are on antiretroviral therapy can safely undergo vasectomy. Special arrangements are needed to perform vasectomy on a man with AIDS. Delay the procedure if he is currently ill with AIDS-related illness.
Spermicides (including when used with diaphragm or cervical cap)	Can safely use spermicides.	Should not use spermicides if at high risk of HIV, infected with HIV, or has AIDS.	Should not use spermicides.
Hormonal methods(combined oral contraceptives, progestin-only pills, progestin-only injectables, monthly injectables, patch, ring, implants)	Can safely use any hormonal method.	Can safely use any hormonal method unless she is on ARV therapy that includes a ritonavir-boosted protease inhibitor. See column to right. →	If her ARV therapy includes a ritonavir-boosted protease inhibitor, she generally should not use combined oral contraceptives, progestin-only pills, monthly injectables, the patch, or the ring. This type of ARV may make these methods less effective. She can use progestin-only injectables or implants. Women whose ARV therapy does not include a ritonavir-boosted protease inhibitor can use any hormonal method.
Combined oral contraceptives, combined injectables, combined patch, combined ring	Can safely use combined hormonal methods.	Can safely use combined hormonal methods.	A woman can use combined hormonal methods while taking ARVs unless her treatment includes ritonavir.
Progestin-only pills	Can safely use progestin-only pills.	Can safely use progestin-only pills.	A woman can use progestin-only pills while taking ARVs unless her treatment includes ritonavir.
Progestin-only injectables and implants	No special considerations. Can safely use progestin-only injectables or implants.

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