Hormonal contraception is one of the modern marvels of medicine. It allows women to make choices about fertility and helps reduce maternal and infant mortality. A new study published in PLOS Medicine however suggest that in some instances one specific form of injectable contraception, is associated with an increased risk of acquiring HIV.
The injectable associated with this increased risk is medroxyprogesterone acetate ( DMPA). The study shows that women using this form of contraception, have a 50% increased risk of acquiring HIV compared to women not using any form of hormonal contraception. This increased risk was noted despite controlling for other factors that could potentially increase risk, such as condom use and the number of sex partners. This is obviously a very large increase in risk. The findings seem to corroborate findings of another recent study published in The Lancet, where the researchers found a 40% increased risk of acquiring HIV in women using DMPA. In another study published in the British Journal of Clinical pharmacology researchers found that using any form of hormonal contraception for at least 5 years could potentially increase the risk of developing glioma, a rare brain tumour, although a risk benefit analysis still suggest that the benefits of using hormonal contraception outweighs this risk.
There is still an ongoing debate on whether using hormonal contraception increases the risk of acquiring HIV and as more evidence seems to point that way, it could have widespread implications for sexual health especially in sub-Saharan countries.
Whilst the data is quite convincing the study is not without its limitations as it cannot completely eliminate bias. Only time will tell if the association is 100% attributable to the use of this hormonal contraceptive. The researchers have noted that a randomised controlled trial is necessary to provide a more definitive answer to this pressing question. In the meantime the study authors suggest that women with a high risk of acquiring HIV need access to additional safe and effective contraception options, and they need to be counselled about the relative risks and benefits associated with available contraceptive methods.
I would suggest that if you use the above method for contraception, speak to your doctor to discuss the possible risks and benefits to see if it is still the right method for you.