HIV and Hormonal Contraception

The World Health Organization (WHO) recently held a technical meeting to evaluate whether to change its advice regarding couples at risk of HIV using hormonal contraception. There has been evidence indicating that hormonal contraception puts couples at increased risk of acquisition of HIV, transmission of HIV and progression of HIV. The WHO group decided to leave its guidelines as is, i.e. not recommending against hormonal contraceptive use but added the following:

“Some studies suggest that women using progestogen-only injectable contraception may be at increased risk of HIV acquisition, other studies do not show this association. A WHO expert group reviewed all the available evidence and agreed that the data were not sufficiently conclusive to change current guidance. However, because of the inconclusive nature of the body of evidence on possible increased risk of HIV acquisition, women using progestogen-only injectable contraception should be strongly advised to also always use condoms, male or female, and other HIV preventive measures. Expansion of contraceptive method mix and further research on the relationship between hormonal contraception and HIV infection is essential. These recommendations will be continually reviewed in light of new evidence.”

The quality of the clinical trials that the WHO reviewed were considered, by the WHO, to be low. This is scandalous. Given the many university-led trials on this issue, why can’t the WHO and the scientists agree on how a trial on this vital issue should be carried out. Hopefully, they now will.

The WHO statement was met with some sharp criticism for not going further in warning and discouraging women from using hormonal contraception. See http://www.avac.org/ht/d/sp/i/42152/pid/42152.

For the WHO statement, see: http://www.who.int/reproductivehealth/topics/family_planning/Hormonal_contraception_and_HIV.pdf

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