Women using injectable contraceptives are at a higher risk of contracting the HIV-1 infection and more likely to transmit it to their partners than a woman not on contraceptives, a new study has revealed.
The study, which has sparked debate, was recently published in The Lancet Infectious Diseases journal. It found that women using hormonal contraceptives like Depo-Provera, commonly used in South Africa, are twice more likely to acquire HIV-1 than a woman not on contraceptives. It also revealed that they were at higher risk of transmitting the virus to their partners.
Prof Gita Ramjee, director of the HIV prevention Research Unit at the South African Medical Research Council in Durban, said yesterday: “While this was an important finding, women need not panic as more research is needed.
“More studies still need to be done to confirm the findings of the sub-analysis. There are conflicting reports on whether hormonal contraceptives do indeed increase the risk of HIV,” Ramjee said.
The study conducted by Renee Heffron and colleagues assessed the link between women who are using hormonal contraceptives and their risk of getting HIV-1 infection as well as the risk of them transmitting it to their HIV-negative partners.
Seven countries including South Africa where HIV-1 is the common strain, participated in the ground-breaking research. Some 3790 heterosexual couples, where one partner was HIV positive and the other negative, were followed from 2007 to 2009.
Findings showed that out of every 100 HIV-negative women who were using oral or injectable contraceptives, 6.61 acquired HIV-1 when compared to 3.78 who were not using contraceptives. In couples where a man was HIV-negative the rate of HIV-1 transmission from a female who was using hormonal contraception was 2·61 per 100 when compared to 1·51 per 100 where a woman was not using contraceptives.
Ramjee said: “Women need to be aware that this is a significant finding and the importance of using dual protection method such as both contraception and condoms for pregnancy and HIV prevention respectively.”
Contraception has declined in South Africa in the past few years. Although there are no recent statistics, the 2003 Demographic and Health Survey revealed that 65% of married women in South Africa (then) were using some form of contraceptives. It also showed contraceptive use increased among the age group of 25-29 and 35-39 between 1998 and 2003.
While many questions remain unanswered about the link between oral and injectable contraceptives and HIV-1, statistics indicate that women who were between 25-39 years old in 2003 are now the hardest hit by HIV and Aids.
The 2009 National Antenatal Sentinel HIV and Syphilis Prevalence Survey revealed that the HIV prevalence in the 30-34 year olds, which is classified as people either in stable relationships or married, is the highest in the country at 41.1%. The figure is 25% more than the national HIV prevalence which is estimated to be 29%.