Gynecologic care of women infected with HIV

Unfortunately, no single agent provides ideal contraceptive efficacy and good protection against STD acquisition for women with HIV. There are limited and conflicting data available to guide selection of contraceptive method. There are few data on the impact of contraceptives on the clinical course of HIV. Condoms provide the best available method of protection against HIV transmission. There is good evidence that Nonoxynol-9 increases the risk of HIV acquisition. Hormonal contraceptive methods may increase HIV transmission, but the data supporting this are not conclusive. The intrauterine device seems to be safe, as is tubal ligation. Until further data are available and until effective and safe microbicides are developed, condom use must be recommended to women for prevention of HIV infection. Hormonal contraceptive methods or tubal ligation may be recommended to augment the contraceptive efficacy of condoms.