African women using an injectable hormonal contraception such as Depo-Provera are at double the risk of acquiring HIV compared to women using other forms of contraception or no contraception, according to a study.
In addition, HIV-infected women who use hormonal contraception have twice the risk of transmitting the virus to HIV-uninfected male partners.
The study by researchers with the University of Washington involved 3,800 couples in seven African countries. The findings emphasize the need for couples to use condoms in addition to other forms of contraception to prevent pregnancy and HIV, said lead study author Renee Heffron, MD, an epidemiology doctoral student working with the International Clinical Research Center at UW.
“Women should be counseled about potentially increased risk of HIV acquisition and transmission with hormonal conception, particularly injectable methods, and about the importance of dual protection with condoms to decrease HIV risk,” she said.
Jared Baeten, MD, PhD, an associate professor of global health with the International Clinical Research Center, said to his knowledge this is the first prospective study to show increased HIV risk to male partners of HIV-infected women using hormonal contraception.
More than 140 million women worldwide use hormonal contraception, including daily oral pills and long-acting injectables, according to information from the researchers.
“The benefits of effective hormonal contraception are unequivocal and must be balanced with the risk for HIV infection,” Baeten said.
The study included 3,790 heterosexual HIV serodiscordant couples who were participating in two long-term studies of HIV in couples in Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda and Zimbabwe.
Findings showed that using hormonal contraceptives doubled an uninfected woman’s chances of becoming infected with HIV. The risk increased for both injectable (mainly DMPA, or depot medroxprogeterone acetate) and oral contraceptives, although it was not statistically significant for oral contraceptives.
Additionally, women who were HIV-positive at the beginning of the study and using hormonal contraception were twice as likely to transmit the virus to their male partner compared to women who did not use hormonal contraception.
The study appeared Tuesday as an online-first article in The Lancet Infectious Diseases. To view a summary and access the study via subscription or purchase, visit http://bit.ly/nDv8Yb.