In a set of recently published articles, Depovera, a hormonal
contracepptive, has been found to increase the risk for HIV
infection in women in real life in women in Kenya, Lesotho, Malawi
an Zimbabwe. The study noted that injectable contraception was
associated with a minor increase in risk of HIV infection. The
reasons are yet to be defined.
The issue for the continued use of Depovera is and individual
woman's issues: a woman has to be able to define her risk for
contracting HIV. If her partner is infected with HIV, she should be
using condoms. The use of hormonal contraception should be in
conjunction with the use of condom (dual protection).
Past studies have also indicated that hormonal contraceptives have
impact on the viral with the viral load being significantly higher
at the early infection period in persons who seroconvert and are
using hormonal contraceptives than those who have established HIV
infection and are using hormonal contraceptive.
Depovera is still legitimately recommended for use in women who are not exposed to HIV, and assuming that the injections used for giving the contraceptive are safe (clean and sterile). However, in
countries where the HIV incidence/prevalence is high, careful
considerations may need to be given to the use of Depovera (and
possibly other Hormonal contraceptives) as a contraception.
References
1. Hormonal contraeption and HIV prevalence in four African
countries: Pauline M. Leclerc, Nicolas Dubois-Colas, Michel Garenne.
Contraception 77 (2008) 371 -376
2. Natural History and Risk Factors Associated with Early and
Established HIV Type 1 Infection among Reproductive-Age Women in Malawi. Johnstone J. Kumwenda, Bonus Makanani, Frank Taulo, Chiwawa Nkhoma, George Kafulafula, Qing Li, Newton Kumwenda, and Taha E. Taha. HIV/AIDS CID 2008:46 (15 June) • 1913 |