2 January 2012

Zimbabwe: Hormone-Based Contraceptives Double HIV Risk - Study

WOMEN using hormone-based contraceptives have been urged to be properly assessed and counselled following research indicating that the contraceptives double the risk of contracting HIV.

Hormonal contraceptives include the pill and the injection and are used by between 150 000 and 200 000 women in Zimbabwe annually.

Zimbabwe National Family Planning Council executive director Dr Munyaradzi Murwira said women should protect themselves from risks of contracting HIV when using the contraceptives.

"All clients using contraceptives should be properly assessed and counselled on issues relating to STIs and HIV, and then provided with comprehensive information on how to protect themselves from, STIs, HIV and unwanted pregnancy," he said.

Dr Murwira said those using the contraceptives should not panic because their use is known to be generally safe even in HIV positive people. He said ZNFPC was working with guided scientific evidence on the suitability of contraceptive methods registered for use in Zimbabwe.

The council also got technical guidance from the World Health Organisation, United Nations Family Planning Agency and others on new developments regarding use and safety of hormonal contraceptives. "Currently, we use guidelines based on WHO recommendations of 2010 in the provision of contraceptive services," he said.

"These guidelines include recommendations on the safety of contraceptives in HIV negative people and those living with HIV.

"If the guidelines change, the country will craft new policies accordingly."

A recent study from the University of Washington in Seattle revealed that contraceptives such as Depo Provera may double the chances that a woman would contract HIV.

The Washington University study followed 3 790 couples in which one partner had HIV.

In couples where the woman used Depo Provera, the woman was nearly twice as likely to acquire HIV infections from their infected partners as those who used no contraception.

Those women were also twice as likely to transmit the infections to their partners. Depo Provera, is a contraceptive injection used by most women in sub-Saharan Africa for birth control.

The contraceptives provide protection against pregnancy for up to 14 weeks, but the shot must be received once every 12 weeks to remain fully protected.

Health analysts say that like previously published studies, the findings were derived from observational data, which may be biased by self-selection.

WHO confirmed the research that suggests use of hormonal contraception may double the risk of acquiring HIV and transmitting it to a partner.

It said in a statement that it was taking caution against making hasty changes to contraceptive policy or practice and would convene a meeting this year to discuss the study.

"WHO is convening a Technical Consultation of a multi-disciplinary group of experts from 31 January to 1 February 2012 to examine all evidence related to the potential effects of hormonal contraception on HIV acquisition, transmission, and disease progression," WHO said.

The experts, WHO said, would decide through consensus if modifications were needed to the WHO guidelines for hormonal method use among women with HIV or women at risk of contacting HIV.

At least 12 million women in sub-Saharan Africa use injectables and eight million use oral contraceptive pills, while 11 million women use non-hormonal methods.

Over the past 15 years, the number of women choosing to use injectables has grown substantially because the method is highly effective and does not require daily action.

It can also be used privately.

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