Hormonal Contraceptive Eligibility for Women at High Risk of HIV: Guidance Statement

Source
World Health Organization
Date of Publication
2017

The World Health Organization (WHO) convened a technical consultation during 1–2 December 2016 to review new evidence on the risk of HIV acquisition with the use of hormonal contraception. The issue was recognized as a critical one, particularly for sub-Saharan Africa, where women have a high lifetime risk of acquiring HIV, hormonal contraceptives constitute a significant component of the contraceptive method mix and unintended pregnancy is a common threat to the well-being and lives of women and girls.

The consultation developed recommendations, including:

  • Women and couples at high risk of HIV infection continue to be eligible to use all forms of hormonal contraception. Informed decision-making is a key organizing principle and standard in a human rights-based approach to contraceptive information and services (5). A shared decision-making approach to contraceptive use should be taken with all individuals, but special attention should be paid to using this approach with vulnerable populations, such as women at high risk of acquiring HIV.
  • Women should not be denied the use of progestogen-only injectables because of concerns about the possible increased risk. Women considering progestogen-only injectables should, however, be advised about this, about the uncertainty over a causal relationship, and about how to minimize their risk of acquiring HIV.