Avoiding STDs
Patients must understand that if they are HIV positive, they can spread the HIV virus—even if their viral load is undetectable. Also, they need to protect themselves from drug-resistant HIV strains and from other STDs.
Condom use may help reduce the spread of HIV. Patients should use a new latex condom every time they have vaginal, anal, or oral sex. They should not use lambskin condoms because they will not protect against HIV. They should never use an oil-based lubricant such as Vaseline or hand lotion, as these can break down latex condoms. Patients must always practice safer sex. Condoms can also reduce the risk of transmitting HIV and STDs between partners.
If patients are sexually active and wish to avoid pregnancy, they should use a latex condom and spermicidal lubricant every time they have intercourse.
Advise patients that HIV is not spread by casual contact. The virus can only be transmitted if HIV-infected bodily fluid comes into contact with blood or mucous membranes.
If patients inject drugs, they should never share needles with anyone.
Discussing sexual activity and reproductive plans including the use of effective contraception with your patients is critical; in some cases, using more than one method of birth control may be advisable. As part of the evaluation for initiating therapy, women should be counseled about the potential risk should pregnancy occur.
HAART and contraception
Some PIs and NNRTIs may interact with oral contraceptives, which may result in decreases in ethinyl estradiol or increases in estradiol or norethindrone levels. A back-up method of contraception should be used with many antiretrovirals. Sexual activity, the use of contraception, and other treatment factors should be discussed where appropriate.
Please consult Full Prescribing Information, including boxed WARNING, Medication Guide, and Important Safety Information for VIRAMUNE.
