October 4, 2011
"The most popular contraceptive for women in eastern and southern Africa, a hormone shot given every three months, appears to double the risk the women will become infected with HIV," according to a study involving 3,800 sero-discordant couples in Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda and Zambia, the New York Times reports. The study, led by researchers at the University of Washington and published Monday in the journal Lancet Infectious Diseases, also found that when the contraceptive was "used by HIV-positive women, their male partners are twice as likely to become infected than if the women had used no contraception," the newspaper writes. In addition, the study "found that oral contraceptives appeared to increase risk of HIV infection and transmission, but the number of pill users in the study was too small to be considered statistically significant, the authors said," according to the New York Times.
"The researchers recorded condom use, essentially excluding the possibility that increased infection occurred because couples using contraceptives were less likely to use condoms," the New York Times notes, adding that "the evidence suggest[s] that the injectable contraceptive has biological properties that may make women and men more vulnerable to HIV infection." Data from the same study published separately "showed that pregnancy also doubled the risk of women's contracting HIV and of infected women's transmitting it to men," which "may partly be due to increased unprotected sex, but could also relate to hormones, researchers said," the newspaper writes (Belluck, 10/3).
"The results present a significant problem for global health and development," the Guardian writes, adding, "Unwanted pregnancy is a threat to a woman's life and can lead to greater poverty and deprivation for her family" (Boseley, 10/3). "The research, first presented in July in Rome at the meeting of the International AIDS Society, emphasizes the need for couples to use condoms in addition to other forms of contraception in order to prevent pregnancy and HIV, said lead study author Renee Heffron, an epidemiology doctoral student working with the International Clinical Research Center at UW," according to a University of Washington press release (10/3).
In an accompanying commentary, Charles Morrison and Kavita Nanda of FHI360 called for additional research to "provide a more definitive answer" on how hormonal contraception affects HIV transmission and acquisition, the Guardian notes (10/3). According to the New York Times, "[t]he study, which several experts said added significant heft to previous research while still having some limitations, has prompted the World Health Organization to convene a meeting in January to consider if evidence is now strong enough to advise women that the method may increase their risk of getting or transmitting HIV" (10/3).