HIV/AIDS Treatment and Care : Clinical protocols for the European ...

Contents
I. Introduction ............................................................................................................................. 313
II. Background ............................................................................................................................ 314
III. Principles of SRH services for PLHIV ............................................................................... 315
1. General principles ............................................................................................................... 315
2. Principles of HIV testing and counselling .......................................................................... 315
3. Patient counselling .............................................................................................................. 315
IV. Sexual health of PLHIV ........................................................................................................ 317
1. Taking a sexual health history............................................................................................. 317
2. Sexual well-being................................................................................................................ 317
2.1. Sexual dysfunction among women.............................................................................. 317
2.2. Sexual dysfunction among males ................................................................................ 318
2.3. Interactions between erectile dysfunction drugs and ARVs ........................................ 318
2.4. Substance use............................................................................................................... 320
2.5. Aspects of mental health.............................................................................................. 321
3. STIs and RTIs...................................................................................................................... 322
3.1. Partner notification....................................................................................................... 323
3.2. Interactions of STI/RTI drugs and ARVs..................................................................... 324
4. Violence related to gender and sexuality ............................................................................ 325
5. Impact of disabilities and chronic illnesses on sexual health.............................................. 326
V. Contraception ......................................................................................................................... 327
1. Preliminary visit ................................................................................................................... 327
2. Medical eligibility criteria for contraceptive use by women living with HIV ..................... 327
3. General contraceptive methods ............................................................................................ 328
3.1. Barrier methods and spermicides ................................................................................. 328
3.1.1. Dual protection ................................................................................................... 328
3.1.2. Male latex condoms............................................................................................ 328
3.1.3. Female condoms................................................................................................. 328
3.1.4. Other barrier methods (diaphragms, cervical caps)............................................ 329
3.1.5. Spermicides ........................................................................................................ 329
3.2. Low-dose combined oral contraceptives ...................................................................... 329
3.3. Progestogen-only contraceptives.................................................................................. 330
3.4. Combined contraceptives in injectable, patch and ring form ....................................... 330
3.5. Intrauterine devices ...................................................................................................... 331
3.6. Emergency contraception ............................................................................................. 332
3.6.1. Emergency contraceptive pill regimens.............................................................. 333
3.6.2. IUDs as emergency contraceptives..................................................................... 333
3.6.3. Mifepristone........................................................................................................ 333
3.7. Surgical sterilization procedures .................................................................................. 334
3.8. Fertility-awareness methods and coitus interruptus ..................................................... 334
3.9. Lactational amenorrhea method ................................................................................... 334
3.10. Future prospects.......................................................................................................... 334
4. Contraception for women on ARV....................................................................................... 335
4.1. Interactions between ARVs and steroids in hormonal contraceptives.......................... 335
4.2. Interactions between ARVs and IUDs.......................................................................... 336
4.3. Teratogenicity of EFV .................................................................................................. 336
4.4. Adherence to contraception and HIV/AIDS treatment................................................. 336