Here’s to Birth Control! For HIV+ Women too …

July 21st, 2011

I’ll never forget the day my first serious boyfriend’s mother cornered me to say that she was very much looking forward to grandkids, but didn’t want any teen pregnancies in the family. I remember telling her that “for so many reasons” she didn’t have to worry about that. Even if I hadn’t yet fully articulated my beliefs around choice, I had a strong sense of responsibility (and empowerment) when it came to my sexual health. Today, as a sexual health educator, I notice of course, that boyfriend’s mom didn’t mention sexually transmitted infections (STIs). So much “sex ed” messaging (from both abstinence and safe sex camps) remains dominated by avoiding pregnancy. While I’m normally screaming “What about STIs!?” at the TV or madly typing condom reminders in blog comments, today I’m actually going to focus on contraception. Turn the mainstream messaging on its head; here in HIV education circles we often forget to talk about birth control for positive women (HIV positive, that is).

Today, the National Women’s Law Center (NWLC) in the US, is hosting a blog carnival called Birth Control: We’ve got you covered. It’s part of a campaign launched in late 2010 by American women’s health groups, to promote the inclusion of prescription contraceptives on the list of “preventive services” that US insurance companies will have to make available copay free (without a deductable, i.e. for free) as part of president Obama’s healthcare reform. When I first encountered this campaign, I had a brief gloating Canadian moment, until I remembered that we have to pay for our birth control here too …

“Women need access to birth control to prevent unintended pregnancies, plan the timing and size of their families and protect their health. Women know the preventive health benefits of birth control, but we also know the cost to stay on it throughout our childbearing years.” NWLC

For women living with HIV, as long as they are accessing care and taking antiretroviral therapy, there is a less than 2% chance that their baby will be born with HIV. At least in this part of the world, positive women have the ability to choose motherhood. Part of that choice is choosing when to become mothers, and that means thinking about contraception. For those thinking about pregnancy, CATIE has some great information. If you’re a woman who’s not menopausal and not interested in becoming pregnant at the moment, then you need to think about birth control just like everybody else.

Some women choose to use condoms to prevent pregnancy as well as to prevent sharing HIV. Others like to “double up”, using condoms and another contraceptive. Some hormonal contraceptives (hormonal options include the pill, shots, patches …) can interact negatively with your HIV meds, making them ineffective or toxic, or making the birth control ineffective. This just means you’ll have to talk to your doctor about possible interactions to find a prescription that works for you. Whatever you choose, you still need to use a condom to prevent HIV and other STIs. While studies are currently looking at whether IUDs are an option, they are still not recommended for women living with HIV. Again, talk to your doctor. To learn more about these and other options, visit The Well Project.

Here’s to birth control! I’ll let this 3-minute Planned Parenthood video sum up for me; it’s moving and informative: