Effective and safe contraception is crucial for women living with Human Immunodeficiency Virus (HIV) to prevent unintended pregnancy, mother-to-child transmission, disease progression and psychological impact. Anti-retroviral treatments (ART) are known to have many drug-drug interactions, causing a dilemma among physicians in choosing the most suitable contraception for women living with HIV (WLHIV). One of the suitable choices is the long-acting reversible contraceptive (LARC), such as contraceptive implants, but this method is not without issues. This case illustrates an Implanon failure that led to an unintended pregnancy in an HIV-positive woman on anti-retroviral treatment and suffered from depression. Contraceptive implant failure has been reported in co-administration with Efavirenz-based anti-retroviral therapy, with studies demonstrating a decline in serum concentrations of etonogestrel and levonorgestrel.