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Antiretroviral interaction with implant — DFSRH MCQ

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HardPharmacology of hormonal contraceptionAntiretroviral interaction with implantDFSRH

A 35-year-old woman using an etonogestrel implant starts efavirenz-based antiretroviral therapy. She has UPSI and wants to continue the implant if possible. What is the most appropriate management?

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Correct answer: E — Check interactions and add or change contraception if needed

The best answer is “Check interactions and add or change contraception if needed”. Contraceptive interaction management depends on the antiretroviral regimen, not HIV status alone. Efavirenz can reduce etonogestrel exposure and may compromise implant effectiveness, so current interaction guidance and a reliable additional or alternative method should be discussed. Removing an implant without another plan, adding CHC without checking interactions, or using repeated oral EC as a routine backup all create avoidable risk.

Reference: CoSRH/FSRH, Drug Interactions with Hormonal Contraception: https://www.cosrh.org/Common/Uploaded%20files/documents/drug-interactions-with-hormonal-contraception-5may2022.pdf