A large meta-analysis of 12 studies in sub-Saharan Africa found that women who used a type of injectable birth control had a moderately increased risk of becoming infected with HIV. The analysis was conducted by UC Berkeley School of Public Health researchers.
The contraceptive, depot medroxyprogesterone acetate, is sold under the brand name Depo-Provera, and it is administered as a shot every three months.
The findings, published Thursday, January 8, in The Lancet Infectious Diseases, included data from 39,500 women. The researchers selected the studies based upon methodological rigor, such as whether they accounted for the use of condoms.
In addition to Depo-Provera, the studies also examined other commonly prescribed forms of hormonal contraception, such as the injectable norethisterone oenanthate (sold as NET-EN), combined oral contraceptives and progestin-only pills. The other birth control methods did not appear to increase HIV infection risk for women in the general population.
“We embarked on this study because of the inconsistency in the scientific literature on this topic,” said study lead author Dr. Lauren Ralph, who did this research for her UC Berkeley PhD dissertation in epidemiology. “The results have potentially broad implications because hormonal contraceptives remain popular for women worldwide.”
The researchers cautioned that the increased HIV infection risk needs to be considered in the context of the risks associated with not using birth control.
“The most important next steps for women all over the world are to examine ways to broaden women’s contraceptive options and increase uptake of other safe and effective contraceptive methods, and to step up research on new contraceptive methods, especially those that protect against both HIV and pregnancy,” said senior author Dr. Nancy Padian, a UC Berkeley adjunct professor of epidemiology.
Other co-authors of this study are Dr. Sandra McCoy, a UC Berkeley assistant adjunct professor of epidemiology, and Dr. Karen Shiu, who was a research analyst in Dr. Padian’s research group at the time of the study.