Hormonal Contraception & HIV Disease Acquisition: A Limited Review and Reassessment of Findings

July 2009
By Nalini Visvanathan

This paper reviews some of the key studies within the epidemiological literature that examine the relationship between hormonal contraception (HC) use, primarily depot-medroxyprogesterone acetate (DMPA) injectables, and HIV acquisition. 

Recent publication of findings raises lingering questions about the role of DMPA injectables, administered once in three months, in the transmission of the virus. The vulnerability of young females to infection in the epidemic, a phenomenon as yet not fully understood, and of the women engaged in sex work makes it critical to re-examine and reassess the findings that "overall" there is no association between hormonal contraception (HC) use and HIV disease acquisition.

It is critical that the implications of the research findings for subgroups of women in the population such as sex workers, teenage girls and young women are reviewed, reassessed and disseminated so that preventive actions can be taken to save lives while research goes on. From our standpoint, the current state of knowledge on this potential association warrants the activation of the precautionary principle, which is a preventive mechanism when definitive scientific knowledge is unavailable.

UPDATE: October 3, 2011 - The New York Times publishes "Contraceptive Used in Africa May Double Risk of H.I.V.", an article confirming that "The most popular contraceptive for women in eastern and southern Africa, a hormone shot given every three months, appears to double the risk the women will become infected with H.I.V., according to a large study published Monday."

Reviving Reproductive Safety Project

The Reviving Reproductive Safety Project critically examines issues of contraceptive safety, new reproductive technologies, population control and women's health.

The Author

Nalini Visvanathan, Ph.D., MPH is an independent researcher and public health advocate. She has served for three years on the Brigham and Women’s Hospital and Fenway Community Health joint community advisory board, where she became involved with the HIV Prevention Trials Network (HPTN) and later joined the NIH/DAIDS-sponsored working group that recommended guidelines for community involvement in HIV clinical trials. From 2005 through 2006, she was a member of the Harvard Medical and Dental Schools Joint Human Subjects Committee.