Group urges government to close unmet gap of contraception for women living with HIV


THE Federal Government has been urged to ensure that women living with HIV/AIDS in the country have adequate access to effective contraceptive methods in order to make use of a new HIV drug, dolutegravir that manages the infection effectively.

SHEWE Group, a coalition of organisations that focus on HIV and sexual and reproductive health and rights that is behind the campaign said the drug has better treatment options for women living with HIV.

As part of a project that the coalition implemented in Lagos, Abuja and Ondo under the guidance of the International Community of Women Living with HIV, West Africa Region (ICWWA), it is canvassing for women living with HIV to have access to family planning.

According to the latest estimate by the United Nations AIDS (UNAIDS) agency and the National Agency for the Control of AIDS (NACA), 1.9 million people are living with HIV in Nigeria. Of this 1.9 million, the report say 1 million are women aged more than 15 years.

By accessing quality contraceptive methods, the group said the women would be able to use the “dolutegravir” drug which helps manages the disease better than another drug called “efavirenz (EFV).

Iwatutu Joyce Adewole who spoke on behalf of the Shewe coalition explained that the World Health Organisation (WHO) had pronounced DTG as the best anti-retroviral drug for people living with the disease.

Shewe urged the Federal Government to ensure access to quality contraceptive methods for these women in order to protect their pregnancy against neural tube defect. Neural tube defects are birth defects of the brain, spine, or spinal cord. They happen in the first month of pregnancy, often before a woman even knows that she is pregnant.

She added that the drug has fewer side effects and suppresses viral load better than others.

But Adewole said women of reproductive age living with HIV could be at risk by taking the drug if quality contraception was not being used noting that the  infants born by such women could develop neural tube defects.

“It is imperative of government and policymakers in closing the unmet gap of contraception for women living with HIV.

“For women of childbearing potential who prefer the option of DTG regimen should be provided with effective contraceptives.

“Nigeria has one of the lowest modern contraceptive prevalence rates in Africa. Inadequate availability of contraceptives, poor infrastructure and cultural aversion to family planning are some of the impediments to family planning uptake in Nigeria,” the group said.

There are ongoing studies to address the issue of neural tube defect signal among women that are exposed to DTG before contraception or early in pregnancy, according to WHO.

On July 22, the WHO recommended the use of the HIV drug dolutegravir (DTG) as the preferred first-line and second-line treatment for all populations, including pregnant women and those of childbearing potential.

Initial studies had highlighted a possible link between DTG and neural tube defects in infants born to women using the drug at the time of conception as four of 426 women who became pregnant while taking DTG had the defects.

    Based on these preliminary findings, WHO said many countries advised pregnant women and women of childbearing potential to take efavirenz (EFV) instead.

    However, recent data from two clinical trials noted the risks of neural tube defects are “significantly lower” than what the initial studies suggested.

    WHO later considered the drug over other ARV drugs considering the benefits.

    “DTG is a drug that is more effective, easier to take and has fewer side effects than alternative drugs that are currently used. DTG also has a high genetic barrier to developing drug resistance, which is important given the rising trend of resistance to EFV and nevirapine-based regimens,” it explained the drug’s benefits.

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    1. This is beautiful. Women’s right to access reproductive health services is human right. They need to be given accurate information to make informed decisions. Thank you so much for this piece. Kudos to Shewe


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