Injectable contraceptives may increase risk of contracting HIV

She describes herself as a careful person, one who does not take chances with life. These, she says, are two principles that she thought could protect her from contracting HIV from her partner who is positive.

Wednesday, January 25, 2012
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She describes herself as a careful person, one who does not take chances with life. These, she says, are two principles that she thought could protect her from contracting HIV from her partner who is positive.


"We did all what our doctor told us to do, to keep me safe, we followed every order to the letter, but one day when my doctor told me I was no longer HIV negative, I felt as if life had come to an end, I thought I didn’t get him right at first, but another test confirmed I was HIV positive,” Jennifer Wanji said.

She says she demanded for a repeat of the test twice, but this did not change the situation. This only confirmed her fears. Her husband was also astounded by this news and sought to find out just what could have gone wrong. "I had always taken careful steps to protect my wife from contracting HIV, we have always gone for routine checkups and adhered to the doctors instructions on how to go about protecting ourselves from transmission. The news hit us hard,” he says.

It is now two months since the couple received news of what could have possibly caused the transmission. Their doctor told them about a new study, which reveals that women who are HIV negative and using injectable contraception might face a two-fold risk of acquiring HIV from their infected partners. Wanjie had started using injectable contraception not more than six months before and for this the doctor told them that this could have triggered the infection.

Findings by Lancet Journal, a study in seven Sub-Saharan African countries potentially present an alarming quandary for women in Africa. It shows that women using hormonal contraception became infected at a rate of 6.61 per 100 person-years, compared with 3.78 for those not using that method.

The birth control method which is currently used by up to 6 percent of the 12 million women ages 15 to 45 on contraception in the East and Southern African region is preferred by women because it is just a shot every three months and birth control is taken care of. Although it is widely used, the injectable contraception is also associated with several other side effects including delayed return to fertility after using it, menstrual irregularities, weakness and fatigue, abdominal discomfort, hair loss and nervousness.

The study conducted from 2004 to 2010 involved 3,800 couples in several African countries including Kenya, Tanzania and Uganda. Researchers followed most couples for two years, had them report their contraception methods, and tracked whether the uninfected partner contracted HIV.

However, the International Planned Parenthood Federation (IPPF) considers the findings as not conclusive enough and therefore should not be used to draw conclusion on hormonal contraceptive use and its potential role in increasing users risk of HIV acquisition. "There is need for additional research for confirmation and better understanding of the study’s findings and addressing of key outstanding issues and questions,” the agency’s African regional office says.

Voicing similar concerns are family planning experts who have advised women to continue using the injectable contraceptive -- Depo Provera --amid alarms that it could double the risk of contracting HIV. Dr Alex Mbaya told Xinhua that the report is not conclusive enough to advise women to stop using the method. "Women should keep using the injectables, in my own opinion, enough research was not done to come up with such conclusions,” he says.

He says the research was not originally set out to find a linkage between contraceptive use and HIV but this conclusion was a secondary finding of another study that was being carried out. "We agree what happened to Wanjie could have been as a result of using the method but the report does not show how the injections increase the risk of contracting HIV,  the facts are not very clear, women using the method should be assured, no cause for alarm,” he says.

Xinhua