Hormonal contraceptives and ARVs

Can you take hormonal contraceptives with ARVs?

People taking various forms of hormonal contraceptives can likely combine them safely with antiretrovirals (ARVs), whether as HIV treatment or as pre-exposure prophylaxis (PrEP) against the virus. The one ARV that may cause problems with hormonal forms of birth control is Sustiva, please discuss with your health care provider.

Researchers conducted a review of scientific studies published through September 2015, ultimately reviewing 50 reports from 46 studies of people using hormonal contraceptives and ARVs at the same time, whether for treatment or as PrEP. Investigators looked for changes in effectiveness and toxicity of both types of drugs, as well as how the drugs are processed, including changes in drug levels in the body.

The study authors found that whether used as treatment or prevention, most ARVs have little to no interactions with hormonal contraceptives. As mentioned above, the standout was Sustiva. The limited data available suggest that this ARV, may compromise the effectiveness of hormonal birth control, with the exception of Depo-Provera. Despite any interactions with Sustiva, birth control implants in particular remain very effective when paired with the drug.

Hormonal contraceptives do not apparently affect levels of ARVs in the blood or their effectiveness. According to the available data, taking PrEP does not reduce the effectiveness of hormonal contraceptives or vice versa. Kavita Nanda, MD, MHS, director of medical research at FHI 360 in Durham, North Carolina, and the study’s lead author, says most ARVs, whether taken for HIV treatment or as PrEP, “can be used concurrently with hormonal contraceptives without risk of drug interactions. HIV-positive women should continue to be offered contraceptive options that best meet their needs.”

Find out more from this POZ resource.