Hormonal Contraceptives And Increased Risk Of HIV-1 Transmission: Renee Heffron And Jared Beaten Study

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Hormonal injectable contraceptive increases risk of HIV transmission.

A study conducted by Renee Heffron, Jared Beaten, et al and published in The Lancet; indicate that women taking hormonal contraceptive injections are more at risk of contracting and spreading the HIV-1 virus!!! In the countries of southern and eastern Africa, hormonal contraceptive injections administered once every 3 months is the most commonly practiced contraceptive method. However, the results of the study has brought to fore interesting and alarming observations regarding increased risk of spread of HIV virus.

Why are these observations so troubling?

In Africa, lack of primary health care results in women suffering numerous problems like bleeding, infections, injuries etc. during childbirth. The hormonal contraceptive was a blessing in disguise and saved majority of them from unintended pregnancies. Now, the countries with high pregnancy rates also happen to have high incidence of AIDS and thereby prevalence of HIV.

Thus, the observations indicating increased vulnerability to HIV due to use of injectable contraceptive by women is alarming!

Over 6 % of women in the age groups of 15 to 49 in sub-Saharan Africa use these hormonal injectable contraceptives in Africa. The study observed biological changes that rendered women more vulnerable to HIV and this effect would hold true in women wherever they are. In the US alone, over 3 % of women use the same type of contraception. However, the risk of HIV transmission is higher in Africa and therein lies the problem.

Study in Brief

Hormonal contraception - results of study

Transmission of HIV was higher in women who used hormonal contraception.

3,800 couples from various countries in Africa participated in the study.
Among all the couples, one of them (man or woman) was HIV positive.
All the couples were monitored for 2 years and details regarding their contraception methods tracked.
The couples were also monitored to see whether the infected partner would transmit HIV to the uninfected partner.
The study found that women who used injectable contraceptive method became infected at a rate of 6.61 per 100 person annually when compared to the 3.78 who did not.
HIV transmission to men occurred at a rate of 2.61 per 100 person for women annually who used hormonal contraception compared to 1.51 for those who did not.

The physiological change that is caused could be due to presence of progestin in the injectable contraceptives. Progestin can cause ‘immunologic changes in the vagina and cervix’ or increase HIV’s ‘ability to replicate’ concluded the results of the study.

The study has prompted World Health Organization to organize a meeting in January to confirm the findings.