Efavirenz use and contraceptive methods in HIV-positive women in a large urban cohort

Background Despite increasing reports of successful pregnancies whilst using Efavirenz (EFZ), the drug remains Category C during pregnancy due to concerns around teratogenicity [1]. Additionally, EFZ can render many hormonal methods of contraception less effective. For these reasons, UK guidance suggests that HIV positive women should be informed of these effects before commencing treatment [2]. Following a case in this unit where a young HIV-positive woman had an unplanned pregnancy whilst using Implanon and taking EFZ/Truvada, we examined contraceptive use and advice given to women in our cohort using EFZ, and then instigated changes to improve practice in this area. Methods Case-note review of all women taking EFZ in Jan 2008 and again in Feb 2010. Current contraception used, advice on teratogenicity, and advice on efficacy documentation was recorded. Women over 50, with documented menopause or hysterectomy were excluded.