Birth Control and HIV

Table of Contents

• HIV+ Women and Birth Control
• Methods That Protect Against HIV Infection
• Methods That Do Not Protect Against HIV Infection
• Briefs on Other Methods That Do Not Protect Against HIV Infection
• How to Choose

HIV+ Women and Birth Control

All sexually-active women who have sex with men and have not yet completed menopause (have not yet had 12 months without any periods) need to make decisions about which birth control method is best for them. If you are a woman living with HIV (HIV+), your decision should take into account the possibility of passing the virus to your partner. This is true if your partner(s) is HIV+ or HIV-negative.

When both partners are HIV+, you do not need to worry about one getting infected with HIV. However, one partner could re-infect (also called super-infect) the other with a strain of HIV that is resistant to the HIV drugs being taken. Also, other sexually transmitted diseases (STDs) could be passed from one partner to the other. The only forms of birth control that will provide protection against HIV and other STDs are abstinence (not having sex) or using condoms while having sex.

Not all HIV+ women will want to, or be able to, have their partners use condoms, whether their partners are HIV+ or HIV-negative. For HIV+ women who do not use condoms and do not want to get pregnant, there are a number of other choices available. These other methods of birth control offer protection against pregnancy, but do not protect against HIV or other STDs. Some health care providers suggest "dual protection" -- condoms to prevent HIV transmission, and another method to prevent pregnancy.

Methods That Protect Against HIV Infection

Condoms

Condoms are thin latex or plastic barriers. The male condom is worn on the penis. The female condom is put in the vagina or anus.

Benefits:

• Female and male condoms are the most effective ways to prevent many STDs (including HIV)
• Up to 98 percent effective at preventing pregnancy if used correctly; if not always used correctly, condoms are only 85 percent effective
• The female condom is the only female-controlled method of birth control that also provides protection from STDs
• Male condoms are inexpensive
• Do not require a prescription

Drawbacks:

• Male condom requires cooperation of the male partner
• May break if not put on correctly or if used with oil-based lubricants like baby oil or Vaseline
• Male condoms must be put on immediately before or during sex while the male partner is erect
• Female condoms are expensive and not available everywhere

The male condom is available in lubricated and unlubricated (dry) forms. Unlubricated condoms are often the condoms of choice for oral sex. For vaginal sex, you can use either a lubricated or unlubricated condom. For anal sex, lubricated condoms are suggested. You can choose to add lubricant (lube) any time you use a condom. Remember, however, to use only water-based lubes (like Astroglide, KY Jelly) with latex condoms. Oil-based lubricants like mineral oil, cold cream, vasoline (petroleum jelly), and vegetable oils will damage latex and make the condom ineffective at preventing infections or pregnancy.

Condoms lubricated with the spermicide Nonoxynol-9 (N-9) are no longer recommended. They have a shorter shelf life, do not decrease pregnancy more than other lubricated condoms, and may cause irritation of the vagina or rectum (which increases HIV risk).