During 9–12 March 2014, the World Health Organization (WHO) convened a meeting of the Guideline Development Group (GDG) comprising 52 individuals representing a wide range of stakeholders, for the purpose of reviewing, and where appropriate, revising its Medical eligibility criteria for contraceptive use, fourth edition (MEC) guidance. Recommendations concerning the use of hormonal contraceptive methods by women at high risk of HIV and women living with HIV, including women taking antiretroviral therapy (ART), were among the many topics reviewed at this meeting. Given the public health importance of this topic, and at the encouragement of the GDG, the World Health Organization is issuing its contraceptive eligibility guidance for women at high risk of HIV and women living with HIV in advance of the entire guideline revision. It is anticipated that the revised fifth edition of the MEC will be completed in 2015.

Recommendations for hormonal contraceptive use are provided for:

• women at high risk of HIV infection
• women living with asymptomatic or mild HIV clinical disease (WHO stage 1 or 2)
• women living with severe or advanced HIV clinical disease (WHO stage 3 or 4)
• women living with HIV using antiretroviral therapy (ART)

In addition to the recommendations themselves, this publication provides a description of the background and methods used in their development. An executive summary and information on dissemination and evaluation are also included.

Contents

• Acronyms and abbreviations
• Executive summary
• 1. Background
• 2. Methods
  • 2.1 MEC classification categories
• 3. Recommendations
  • 3.1 Recommendations for hormonal contraceptive use among women at high risk of HIV infection
  • 3.2 Recommendations for hormonal contraceptive use among women living with asymptomatic or mild HIV clinical disease (WHO stage 1 or 2)
  • 3.3 Recommendations for hormonal contraceptive use among women living with severe or advanced HIV clinical disease (WHO stage 3 or 4)
  • 3.4 Recommendations for women living with HIV using antiretroviral therapy (ART)
• 4. Dissemination and evaluation of the 2014 guidance statement on hormonal contraceptive methods for women at high risk and living with HIV
• Annex 1 Summary of recommendations for hormonal contraceptive use for women at high risk of HIV, living with HIV, and taking antiretroviral therapies
• Annex 2 GRADE evidence profiles
• Annex 3 References
• Annex 4 Acknowledgements
• Annex 5 Declarations of interest

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