Using hormonal contraception does not appear to increase women's overall risk of infection with the AIDS virus, report the authors of a large study commissioned by the National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health (NIH). The study, published on the Web site of the journal AIDS, is the largest, most comprehensive of its kind to date. It followed thousands of women in Africa and compared their patterns of contraceptive use to their risk of infection with HIV. The NIH project officer for the study, H. Trent MacKay, M.D., M.P.H, Chief of the Contraception and Reproductive Health Branch, said the study findings do not provide a basis for changing current recommendations regarding contraceptive use.
Dr. MacKay cautioned that, although hormonal contraception provides an effective means of pregnancy prevention, it does not protect against HIV or other sexually transmitted infections. Abstinence is the only sure way to prevent sexual transmission of HIV, he said. Barring abstinence, use of a latex condom, consistently and correctly, is highly effective against HIV infection.
More than 100 million women around the world use hormonal contraception, the study authors wrote. In all, 18 million women have been infected with HIV, most during heterosexual relations. "Understanding whether hormonal contraceptive use alters the risk of HIV acquisition among women is a critical public health issue,"the study authors wrote.
The researchers studied use of the most commonly prescribed forms of hormonal contraception: combined oral contraceptives, containing estrogen and progestin, and depot-medroxyprogesterone acetate (DMPA), an injected contraceptive containing progestin only. Numerous studies have considered the issue of whether contraceptives might increase a woman's risk of becoming infected with HIV. The results of these studies, however, are inconclusive. The current study was commissioned by NIH's NICHD to overcome many of the limitations of the previous studies. It was conducted primarily among women seeking family planning services (rather than among high-risk women such as sex workers) who more closely resemble the vast majority of women using hormonal contraception worldwide.
The researchers undertook the study in Africa and Asia because those parts of the world had a very high incidence of HIV infection at the time the study was being planned. Because there are comparatively fewer new cases of HIV infection in the United States, any U.S.-based study would take far longer to provide results.
Marianne Glass Miller
Message posted by: Rashmi Nemade
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