International Planned Parenthood Federation (IPPF) responds to new World Health Organization (WHO) antiretroviral treatment guidelines recommending dolutegravir (DTG)-based treatment for women and girls. The drug’s high success rate has led to DTG rollout in many countries for people living with HIV globally than other current first-line treatment options. IPPF is concerned the guidelines could result in women living with HIV being coerced to use contraception or take less effective HIV treatment options.
Organizations led by women living with HIV have raised concerns that the WHO recommendation undermines choice for women by placing reproductive success above treatment success. All women should make informed choices about both their HIV treatment and contraception options, including the potential risks and benefits.
Alvaro Bermejo, IPPF Director General said:
"We support the need for more effective HIV treatment options to be available and that the WHO guidelines have been reviewed due to safety and efficacy during pregnancy. But with the rollout of DTG in more countries, it is vital that governments and health providers ensure that treatment options are offered through a women-centred approach. Free from any coercion of contraceptive use over HIV treatment options.
"We know that sexual and reproductive ill-health and HIV share root causes. Better integration of HIV and sexual health care means that more women and girls can make the best choices about their health and wellbeing."
As stated in the WHO consolidated guidelines on sexual and reproductive health and rights of women living with HIV, care should be provided in ways that respect women’s autonomy in decision-making about their health, and women should have the information and options to enable informed choices.
Dolutegravir is a highly effective HIV integrase inhibitor with a high barrier to the development of drug resistance. Countries are shifting to dolutegravir as first-line treatment, including Botswana, Brazil and Kenya adopting DTG with many more to follow.
IPPF is developing a technical brief on this new treatment guidance to be distributed to all Member Associations, and will follow the evidence and updated information as it becomes available.