Posted by: rachelhampton | 08/01/2011

Hormonal birth control increases women’s risk of HIV acquisition and transmission

A new study presented at the International AIDS Society Conference in Rome found that women who take hormonal contraceptives are at a greater risk of acquiring HIV and transmitting it to their male partners than women who do not take hormonal contraceptives.  The study, conducted by the University of Washington, included 3790 serodiscordant couples from seven African countries over a two year period. These findings contribute to a growing body of scientific literature on the association between hormonal contraceptive use and HIV infection, although to date the results of these studies are mixed.

Twenty-one percent of all women included in the study had used hormonal contraceptives at least once during the study period, with more women using injectables (16 percent) than oral contraceptives (7 percent).  These women were about twice as likely to acquire HIV than women who did not use contraceptives, and the women using injectable contraceptives were at even great risk compared to the women who used oral contraceptives. Additionally, men included in the study whose partners used hormonal contraceptives also had a two-fold greater risk of acquiring HIV than men whose partners did not use hormonal contraceptives.

The study had a number of important limitations to consider. It did not collect data on the specific brands of oral or injectable contraceptives used by women, which is important because contraceptives have a variety of different formulations and acting mechanisms. Furthermore, the study did not record the duration of hormonal contraceptive use by different women. Both of these factors may affect a woman’s risk of HIV acquisition and transmission.

The study also has a number of important implications. First, it reemphasizes the importance of condoms as a means to prevent both pregnancy and HIV transmission.  Second, it underscores the need to continue to promote alternative forms of non-hormonal contraceptives, such as the intrauterine device (IUD), especially in areas with high HIV prevalence. Third, it highlights the need for specialized family planning information and services for men and women living with HIV. However, it would be a mistake to assume that the findings of the study imply that women should stop using hormonal contraceptives. Hormonal contraceptives have many health benefits, enable women to exercise their reproductive rights, and are key to reducing maternal mortality.

More research is needed to confirm the findings of this study and further explore the link between hormonal contraceptives and HIV, including the biological mechanisms that may explain increased risk.

Read the abstract of the study.


Responses

  1. Hormonal contraceptives and HIV: interesting study, makes one wonder if that actually lowers the efficiency of the fighting mechanism in the body .

  2. This blog posting indirectly brings to light the fundamental cause of HIV transmission; the lack of education. Family planning educators play an important role in providing the public with the necessary tools to make informed decisions about their family’s future. As far as hormonal contraception in females, this type of contraception gives the female a false sense of control over her sexuality. The female makes a decision regarding the distant future, a decision on child birth. However, her own personal safety is not directly addressed. Hormonal contraception do not protect from HIV transmission. Women on Hormonal contraception are least likely to practice abstinence or require their partner to wear a condom. Therefore, putting these women who use hormonal contraception at a higher risk of contracting and transmitting HIV.

  3. Maybe I’m misunderstanding this article somehow, but it is as if the study is saying that women are acquiring HIV because they use hormonal contraceptive. If so, the study was a waste time and resources. I believe that one as nothing to do with the other. Moreover, the study does not seem to address the false sense of security these women may feel by taking this form of contraceptive. As the previous comment states, these women are making decision on childbirth, not their personal safety. There needs to be an emphasis on information, education, and communication. These women should be informed about the facts of HIV, educated about ways to prevent transmission (i.e. condom use), and taught how to communicate this information with their partners.

  4. Within the Global Health 101 textbook by Richard Skolnik, women are more biologically susceptible to some sexually transmitted infections than men, especially the human immunodeficiency virus (HIV) because of more exposed mucosal membranes (Skolnik, 2012). Within many societies globally, women are inferior in terms of social, health and economic problems, and often forced to have sex and many times without condoms (Skolnik, 2012). Therefore, women are at a higher risk of becoming pregnant, which in turn leads them to use oral or injectable contraceptives that are not, meant to substitute for protective barriers such as the condom. I believe; knowledge deficit is the primary reason why women are more vulnerable than men as previously mentioned in the comments. As a common misconception must be assumed that contraceptives alone protect from sexually transmitted infections (STI) while, in fact, additional protective barriers are necessary. Therefore, I believe it is the responsibility of health professionals to educate both men and women; while also provide cost-effective services in family planning to prevent further STI outbreaks locally and globally (Skolnik, 2012).

    Skolnik, R. (2012). Global Health 101 (2nd ed.). Burlington, MA: Jones & Bartlett Learning.


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