Tagged: Depo Provera

  • Exploring the potential link between hormonal contraceptive use and HIV acquisition

    morrison_charles_2012_220x200Are women who take hormonal contraceptives at an increased risk of acquiring HIV? If so, do some contraceptives put women at higher risk than others?

    This week, the influential health journal, PLOS Medicine, published the results of a large individual-participant data meta-analysis, authored by FHI 360 and collaborators, that seeks to answer these questions.

    While this issue matters to the field of reproductive health, it is especially critical to women in East and Southern Africa. In these regions, women potentially have a double risk factor: high rates of HIV and high use of hormonal contraception, particularly depot-medroxyprogesterone acetate (DMPA), a type of contraceptive that is injected every three months. So far, the evidence on DMPA shows that it is the hormonal contraceptive that has the most potential to increase HIV acquisition; however, the evidence is inconclusive.

    FHI 360’s meta-analysis combines the results of 18 prospective studies, including more than 37,000 women, of whom more than 1,800 became infected with HIV. We found that women who used DMPA had a 50 percent increased risk of HIV acquisition compared with women who did not use hormonal contraceptives. We found no significant increase in HIV risk among women using combined oral contraceptives (COCs) or norethisterone enanthate (Net-En), a contraceptive injected every two months. Women using DMPA also had an increased HIV risk when compared directly with COC or Net-En users.

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  • The votes are in for injectable contraceptives

    Women in sub-Saharan Africa are voting with their feet. Or in the case of injectable contraceptives, they are voting with their arms.

    Injectable contraceptives — which are typically administered in the upper arm and provide protection from pregnancy for 1-3 months depending on the formulation — are the most commonly used family planning method in sub-Saharan Africa, with more than one-third of contraceptive users choosing this method, according to a United Nations report. Worldwide, over 40 million women use injectable contraceptives, mainly depot medroxyprogesterone acetate — commonly known as Depo-Provera or DMPA.

    Nineteen year old Masani* from Tanzania chose injectables because she wanted an effective method that was convenient and didn’t require daily action. When offered oral contraceptives at the clinic, she declined. “I will fail because I will forget,” she explained. Some women say that they appreciate injectable contraceptives because they do not require a more invasive medical procedure. For Masani, the familiarity of DMPA was appealing. “That one I can understand,” she said.

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