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How does HIV therapy affect hormonal contraception?

Limited evidence suggests that certain antiretroviral (ARV) drugs can either raise or lower concentrations of contraceptive hormones in the blood of HIV-infected women using combined oral contraceptives (COCs). Theoretically, lower contraceptive hormone levels could reduce contraceptive efficacy and increase pregnancy risk, while higher levels could increase hormone-related side effects. (1)

Unanswered questions about the effects of ARV-COC interactions have led the World Health Organization (WHO) to caution that, although women on ARV therapy generally may use oral contraceptives, medical follow-up may be appropriate. (2) Questions about interactions between ARV drugs and ...

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