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Subdermal implants are among the most effective contraceptives available and therefore represent a leading choice among HIV-infected women for preventing mother-to-child transmission. However, progestin blood levels are lowered when efavirenz-based antiretroviral regimens are used concurrently with combination oral contraceptives (NEJM JW Womens Health Apr 28 2011), and in two case reports, women became pregnant while using efavirenz and subdermal implants (NEJM JW Womens Health Dec 15 2011).
Now, data from 570 HIV-infected African women who used the Jadelle two-rod subdermal contraceptive show that 12% of women who also received efavirenz became pregnant. In contrast, none of the women who received nevirapine or lopinavir/ritonavir while us…