All the mainstream media have been running the story about recent research which shows that hormonal contraception commonly used in African countries substantially increases the risk of HIV infection, for both women and men.
There is now an urgent need to give people advice that will protect them from harm, while also offering them the most effective and acceptable forms of birth control, without risking infection with sexually transmitted infections (STI).
Something that is not mentioned by the copious media articles on the issue is that, because the most popular means of administering hormonal contraception in African countries is by injection, this may point to an additional factor in the rapid spread of HIV; injection safety may have improved in the last ten years or so, but during periods when HIV transmission rates were highest, it is possible that injecting equipment was used in ways that did not protect against HIV transmission.
Sexual and reproductive health programs have had a poor record in emphasizing the dual use of family planning methods, for preventing unplanned pregnancies and for protecting against STIs. The programs may not have adequately convinced people of the need for protection against STIs.
After all, many of the people who have been infected with HIV would not consider themselves to be particularly promiscuous or careless, and rightly so. The majority of people infected in countries such as Kenya, Tanzania and Uganda were not at high risk on account of their sexual behavior.
The thrust of this blog and website is to emphasize that HIV can be transmitted through unsafe sex and through unsafe healthcare and cosmetic services. The need to investigate the role of unsafe injections in the administration of hormonal contraceptives is as urgent as that of the role of these contraceptives in increasing HIV transmission.
The manufacturer of a popular version of injectible contraceptive, Depo-Provera, is Pfizer. Instead of declining to comment on the grounds that they haven’t read the study (it’s not that long) they could break new ground in HIV prevention by leading the investigation.
One commentator suggested greater use of “intrauterine devices, implants and other methods” on the grounds that if use of injectible contraception is to decrease, there needs to be a viable alternative. But some of these methods may also carry HIV transmission risks, something that should be explored thoroughly by those thinking of changing contraception method.