Lecture | Quiz | Learning Exercise | Answer Key

Developed by JHPIEGO’s Training in Reproductive Health Project with funding from USAID.

Lesson 6: Hormonal Methods, IUDS, Fertility Awareness Methods, and Voluntary Surgical Contraception
Instructor: Emmanuel 'Dipo Otolorin, MD

Answer Key

Quiz 

1. The following are non-contraceptive benefits of combined oral contraceptive pills EXCEPT:
   1. Protects against ovarian cancer
   2. Protects against endometrial cancer
   3. Increases blood loss leading to anemia
   4. Decreased menstrual cramps
   5. Reduced incidence of acne
2. The following drugs interact with oral contraceptives: 
   1. ritonavir, 
   2. efavirenz
   3. rifampicin, 
   4. methydopa
   5. All of the above 
3. A 35 year-old woman living with HIV/AIDS has come to the family planning clinic 2 weeks after delivery of her second child. She is currently breastfeeding and has asked you for advice about contraception. She may use any of the following methods EXCEPT:
   1. Combined oral contraceptives and condom
   2. Progestin only contraceptives and condom
   3. Intrauterine device (IUD) and condom
   4. Female sterilization and condom
   5. Condom alone
4. Benefits of the IUD include the following EXCEPT:
   1. High effectiveness 
   2. Protects against HIV infection
   3. Not user dependent
   4. Can be inserted by non-physicians
   5. Inexpensive on the long term

Learning Exercise

Mrs X, a 25 year old woman with 2 children aged 6 and 3 years, has just been informed that she is HIV positive. She has been in a monogamous relationship with her husband for many years and has used the IUD for contraception in between pregnancies. Her current IUD was inserted 6 months ago and she has had no complaints since then.

Following a diagnosis of pulmonary tuberculosis in her husband, the couple was advised to go for VCT. The results confirmed that both husband and wife are HIV positive.

1. What additional questions will you ask the couple?

   1. Does either of them have any other sexual partner(s)?
   2. Is there a history of injection drug use in the family?
   3. Has either of them been previously transfused with blood?
   4. Has either of them been diagnosed with or treated for an STD?
   5. What are the couple’s reproductive intentions?
2. What advice will you give her about contraception?

   1. Dual protection is indicated in this case.
   2. The woman can continue the use of her IUD to prevent unintended pregnancy, provided neither the husband nor wife has other sexual partners. If either of them has other sexual partners, then the IUD should be removed and the couple should be counseled to choose an alternative contraceptive method (e.g. norplant, combined oral pills, male or female sterilization)
   3. In addition, since the IUD does not protect against HIV transmission, the couple should use the male or female condom to prevent reinfection by new HIV organisms.