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.