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Hormonal contraception and HIV: consensus statement.

The World Health Organization Headquarters Office and Regional Office for Africa, in partnership with the Reproductive Health and HIV Research Unit of the University of Witwatersrand in South Africa, International Planned Parenthood Federation Africa Region and Family Health International (FHI), convened a meeting of 72 representatives from 17 francophone, lusophone and anglophone sub-Saharan African countries on hormonal contraception and HIV: science and policy. The meeting reviewed data and information on the association between use of hormonal contraception and the risk of acquiring HIV infection.

A study published in 2004 on a cohort of sex workers followed over many years in Mombasa, Kenya, showed that users of hormonal contraception have a 1.5-fold (combined oral contraceptives [COCs]) to 1.8-fold (depot-medroxyprogesterone acetate [DMPA]) higher risk of acquiring HIV infection compared with non-users. Other studies conducted among sex workers have found similarly elevated risks. Two new studies, one in Uganda, Thailand and Zimbabwe, the other in South Africa, that are pending publication, conducted among family planning service users, found no overall increase in risk of acquiring HIV infection in women who used hormonal contraception compared with women who used non-hormonal contraception or no contraceptive method.

The meeting recommended that there should be no restrictions on the use of oral contraception and DMPA by women at risk of acquiring HIV, consistent with the current WHO Medical Eligibility Criteria for Contraceptive Use guidelines. However, participants suggested that the Guidelines Steering Group reconsider its classification regarding women at high individual risk of HIV infection, for whom some caution on use of these methods may be appropriate. The meeting reiterated the importance of promotion of condom use and called for training for family planning providers in promoting use of dual protection against STIs/HIV and unwanted pregnancy. (1)

(1.) Hormonal contraception and HIV: science and policy. Statement (final), September 2005.
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Title Annotation:ROUND UP: HIV/AIDS
Publication:Reproductive Health Matters
Geographic Code:1USA
Date:Nov 1, 2005
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