By Sharon Atieno

There is no link between HIV infection and contraceptive methods, results from the Evidence for Contraceptive Options and HIV Outcomes (ECHO) study reveal.

The clinical study conducted in eSwatini, Kenya, Zambia and South Africa found that there is no substantial difference in risk of HIV infection among women using copper intrauterine devices (IUDs), levonorgestrel implant (jadelle) and depot medroxyprogesterone acetate- intramuscular (DMPA-IM).

According to the study-published in the Lancet, each method had high levels of safety and effectiveness in preventing pregnancy with all methods well tolerated by the women using them.

“These results support making available to women and girls a broad choice of effective contraceptive methods that empower them to make informed decisions about their own bodies –including if and when to have  children,” said Dr. James Kiarie, from the Department of Reproductive Health and Research at the World Health Organization (WHO).

Currently 214 million women in developing countries want to avoid pregnancy but do not use a modern contraceptive method.

“Better access to contraception and quality reproductive health services would have a dramatic impact in improving the lives of millions of women and their families,” he said.

However, the study found that incidence of HIV infections among all of the women participants was high- an average of 3.8 percent annually. This is alarming as the WHO guidelines for oral PrEP say that a 3 percent rate of new infection is the definition of “substantial risk”.

Out of the 7 829 women who took part in the study, 397 HIV infections occurred. This is despite the women receiving ongoing health services such as counseling on HIV prevention and care, screening and treatment for sexually transmitted infections.

The results further indicate that 143 infections were women using DMPA-IM, 138 were women using copper IUDs while 116 was in women using jadelle.

Moreover, the rate of HIV infection was found to be higher for women younger than 25 years old irrespective of the method of contraception used.

“The study highlights the need to step up HIV prevention efforts in these high-burden countries-particularly for young women,” said Dr. Rachel Baggaley from WHO’s HIV and Hepatitis Department. “These should include providing HIV testing and a range of HIV prevention choices within contraceptive service programmes.”

The WHO in a statement notes that there is need to strengthen HIV prevention integration within contraceptive and other sexual and reproductive health services. HIV testing and linkage to antiretroviral therapy for those testing HIV positive, partner testing, condom promotion, and pre-exposure prophylaxis (PrEP) are among such services.

While WHO will convene a Guideline Development Group to review its existing recommendations concerning women’s eligibility for using various contraceptive methods, updated recommendations will be issued by the end of August 2019.

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