It is known that barrier methods, especially condoms, are the most effective means of preventing the spread of HIV. However, in developing countries, regular condom use is difficult for a variety of reasons; thus, for contraceptive purposes, an injection of birth control hormones, which lasts for months, can be more feasible. However, a study published last year in the Lancet Infectious Diseases found that women using injectable hormones double their risk of becoming infected with HIV, while also increasing transmission rates. In the face of this disconcerting news, in January the World Health Organization (WHO) held a conference of 75 experts from 18 countries in order to determine the best course of action.
The panel concluded that women who are at high risk of acquiring HIV (or who already have the virus) should continue to use hormone injection contraceptives to prevent pregnancy.
Hormone injections are the most popular form of birth control in Africa, particularly because they are effective for months and do not require taking a daily pill. Yet considering that the goal is to prevent both HIV and unintended pregnancies in Africa, whose population accounts for 70 percent of all HIV and AIDS cases, the latest findings on injectable hormones have put health officials in a quandary. After weighing all the scientific evidence, however, the WHO s Guidelines Review Committee accepted the panel s recommendation to continue using this form of contraceptive, while emphasizing the importance of using condoms as well to prevent the spread of HIV.
The situation is indeed a conundrum, agrees ACSH's Dr. Gilbert Ross. Yet it s important to avoid basing decisions solely on just one study. And although the panel recommends condom use, it s necessary to have other forms of birth control available since barrier methods of contraception may not be widely used among these populations.
