Dolutegravir (DTG) and women’s right to choose

In May 2018, the World Health Organization (WHO) issues a safety concern about DTG use in women of childbearing potential. It follows evidence from the Botswana ‘Tsepamo’ study which found a small link between DTG use at the time of conception and neural tube defects in infants.

In response, many countries ban women of reproductive age from taking DTG.

These events highlight women’s need for contraceptives as well as the importance of involving women in decisions about their treatment, sparking a number of high-level community dialogues across different national contexts.

The most notable is the Kigali meeting in Rwanda in July 2018, where African Community Advisory Board (AfroCAB) gathered women living with HIV from 18 countries to develop a joint position statement on access to DTG.

They took a unanimous decision against the blanket exclusion of dolutegravir and instead argued that women should be given an informed choice about their treatment and reproductive health. They also highlighted the need to better integrate contraceptive and HIV treatment services.