- Category: HIV Prevention
- Published on Friday, 21 March 2014 00:00
- Written by Gregory Fowler
South African women who used the injectable hormonal contraceptive DMPA had a significantly higher risk of becoming infected with HIV than women using a different injectable method, according to a report presented at the 21st Conference on Retroviruses and Opportunistic Infections (CROI 2014) this month in Boston.
[Lisa Noguchi, CROI press conference, March 5, 2014]
Lisa Noguchi from Johns Hopkins Bloomberg School of Public Health and colleagues performed a planned sub-analysis of women in the VOICE study, a trial of tenofovir-based pre-exposure prophylaxis using daily pills or vaginal gel. They compared women who used DMPA (depot medroxyprogesterone acetate, or Depo-Provera) versus those who used norethisterone enanthate (NET-EN), 2 widely used long-acting injectable contraceptives.
Looking at more than 3000 women at study sites in South Africa, the researchers found that DMPA users were, on average, older, more likely to be married and have children, and less likely to have multiple sexual partners. Nevertheless, women who used DMPA were significantly more likely to acquire HIV than those who used NET-EN.
Women taking DMPA were also more likely to have herpes simplex virus type 2 (HSV-2), the usual cause of genital herpes. When the analysis was limited to women without HSV-2, there was no difference in HIV risk according to contraceptive use. Among HSV-2 positive women, however, those using DMPA had twice the risk of HIV acquisition as women using NET-EN.
These findings support the idea that women need as many effective means of contraception as possible, as well as effective methods for preventing HIV, Noguchi said.
LS Noguchi, B Richardson, ZM Chirenje, et al. Injectable Contraception and HIV Acquisition in the VOICE Study (MTN-003). 21st Conference on Retroviruses and Opportunistic Infections (CROI 2014). Boston, March 3-6, 2014. Abstract 847.