DOES DEPO-PROVERA CONTRACEPTIVE INJECTION INCREASES HIV RISK BY 40%?

FALSE: DEPO-PROVERA CONTRACEPTIVE INJECTION DOESN’T INCREASE HIV RISK BY 40%

A major study published in 2019 found that women using Depo-Provera had a risk of HIV infection number higher than 30%, compared to other contraceptives

South African Twitter user said the Depo-Provera injection led “to over 40% increase for women to contract HIV-1”. The link between the contraceptive and HIV risk has been debated since the 1990s.A study of 7,829 women in four African countries ruled out an increased risk of more than 30%, when Depo-Provera was compared to other contraceptives.  But a larger study would be needed to detect a difference in risk below 30%, which an expert says could be relevant for women living in areas with high levels of HIV infection.

Does a widely used contraceptive injection increase women’s risk of human immunodeficiency virus (HIV) infection by over 40%? A Twitter user has twice made the claim, in March and April 2020, to his 29,000 followers. His tweets were shared more than 1,000 times and “liked” more than 1,500 times.

Injectables are the most common form of contraception in sub-Saharan Africa, according to the United Nations’ Contraceptive Use by Method 2019 report.

The tweets specifically name the injectable DPMA, or depot medroxyprogesterone acetate, and its brand name, Depo-Provera. The link between Depo-Provera and higher risk of HIV infection has been debated in the medical community since the late 1990s.

Does the drug increase a woman’s chance of becoming HIV positive? And is the risk as high as 40%? We checked. Depo-Provera is an injectable hormonal contraceptive that lasts for 13 weeks. It slowly releases the synthetic hormone progestogen into the bloodstream to prevent pregnancy.

The drug stops ovulation, the monthly release of an ovum, or human egg. It also thickens the cervical mucus and thins the lining of the womb.Depo-Provera is provided in several hospitals

Since the early 1990s there have been concerns that Depo-Provera may increase a woman’s risk of HIV infection.

A 2015 article in the Lancet medical journal examined data from 26 studies looking at various hormonal contraceptives and rates of HIV infection. It found “evidence of a small but increased risk of HIV acquisition” associated with Depo-Provera when compared to oral contraceptives and another injectable contraceptive, Noristerat. But the authors concluded that the risk was not high enough for Depo-Provera to be withdrawn.

A second study found a “statistically significant” increase in HIV infection among Depo-Provera users, in some cases as high as 41% compared to Noristerat users.

These concerns prompted the World Health Organization (WHO) to change Depo-Provera’s “medical eligibility criteria” in 2016. Before, it could be used without restriction as a category one contraceptive.

It was moved to category two for women at high risk of contracting HIV. These included adolescent girls and young women in southern and eastern Africa. The new guidance said: “Women considering progestogen-only injectables should be advised about these concerns, about the uncertainty over whether there is a causal relationship, and about how to minimise their risk of acquiring HIV.”

Conclusion: Depo-Provera doesn’t increase HIV risk by over 40% – but risk under 30% not yet researched

Since the late 1990s, the medical community has debated whether the Depo-Provera contraceptive injection increases women’s risk of HIV infection.

In March and April 2020  a Twitter user claimed the injection led “to African Women contracting HIV-1 by over 40%”.

The Echo – Evidence for Contraceptive Options and HIV Outcomes –  trial examined HIV risk with three contraceptives, including Depo-Provera, in four African countries. It concluded that when the contraceptives were compared to each other, the increased risk of HIV transmission was not greater than 30%.

This information was first published by Africa Check.

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