It was a global health Catch-22: Women’s ability to prevent unintended pregnancies is pivotal to the fight against HIV, but researchers had deduced that one of the most widely used and effective methods of contraception in areas hardest hit by the epidemic could increase transmission of the virus.
Research released last year, following earlier studies suggesting a link between hormonal contraception for women and heightened risk of HIV transmission, was particularly disturbing because pregnancy, also, has been found to increase the chances that a woman will get the virus that leads to AIDS. In addition, pregnancy in poor countries with weak health care systems and limited access to safe abortion, is a life-threatening risk to women in its own right.
Now the Centers for Disease Control and Prevention has followed the World Health Organization in evaluating the studies and in concluding that a link between hormonal contraceptives and heightened HIV risk has not been established. The analysis, published in CDC’s June 22 Morbidity and Mortality Weekly Report affirmed the agency’s previous recommendations that the use of hormonal contraceptives is safe for women at risk of HIV infection or living with HIV and that all women who use contraceptives other than condoms should be counseled to use condoms as well, to reduce their risk of getting sexually transmitted infections.
Noting weaknesses in research linking hormonal contraception to greater risk of contracting HIV, transmitting it to a male partner, and speeding progression of the disease in those already infected, the agency added a warning to its existing recommendations, however, that evidence linking the use of injectable, progestin-based hormonal contraception and HIV acquisition remains inconclusive and merits further examination. In the meantime, however, the report concluded that contraception is “critically important to prevent unintended pregnancy among women at risk for HIV infection or infected with HIV, and such women can continue to use all hormonal contraceptive methods without restriction.” The conclusion also stressed the role of access to testing and treatment, as well as condoms, in limiting the spread of the virus.