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Depo advocates vs. women’s rights

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Anyone who offers Depo to women should tell about risks. This is simply good behavior, caring about others. It also a medical ethics and human rights issue.

But that’s often not the case, as Health-E news reported from South Africa in early 2018[1]:

Pfizer’s Depo Medroxyprogesterone acetate, commonly known as Depo-Provera, is a contraceptive injection given every three months which was introduced in South Africa in the 1970s and largely given to black women as part of the apartheid government’s population control agenda.

Multiple reports and research papers tell of how women were either forced to accept the drug or were given it without their knowledge, especially after giving birth. In democratic South Africa, there are laws requiring informed consent exist aimed at protecting women’s autonomy over their own bodies. But the practice of injecting women with Depo-Provera without proper informed consent – especially those who are poor, black and using the public health sector – is still happening, especially after an abortion or birth.

“It is happening right now. Today,” said Dr Tlaleng Mofokeng, one of the country’s most vocal sexual reproductive health rights experts and activists. “Our society never cared about black women in the past and still doesn’t.”

WHO and prominent aid organizations have been hip-deep in deceiving women about Depo risks. As early as 2012, Paula Donovan, co-founder, AIDS-Free World challenged WHO and other family planning advocates to tell women that Depo may increase their risk to get HIV[2]:

Women’s rights to informed consent are sacrosanct… When a woman receives a hormonal contraceptive injection to protect against pregnancy for three months… [s]he must be clearly informed that unless she uses the condoms, she may be at increased risk of HIV… No global experts or family planning organizations have the right to censor the life-and-death information women need in order to weigh their own risks… Women need information: complete, uncensored, and factually correct.

Here’s what the World Medical Association says about patients’ rights[3]:

Physicians and other persons or bodies involved in the provision of health care have a joint responsibility to recognize and uphold these rights… The patient has the right to the information necessary to make his/her decisions… Every person has the right to health education that will assist him/her in making informed choices about personal health and about the available health services…

Here’s what the United Nations’ Beijing Platform for Action, says about women’s rights to information about birth control methods and risks[4]:

Reproductive health therefore implies…the right of men and women to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice…

Not until 2017, after ignoring and denying evidence for decades, did WHO finally recommend warning women that Depo might increase their risk to get HIV. But even now, WHO still downplays the evidence[5]:

There continues to be evidence of a possible increased risk of acquiring HIV among progestogen-only injectable users. Uncertainty exists about whether this is due to methodological issues with the evidence or a real biological effect… 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 minimize their risk of acquiring HIV.

Paula Donovan[6] and Edra Spevak[7] urge telling women about Depo risks and offering alternate and safer birth control interventions.

References

  1. Green A. Health-e news: contraception, HIV and control over black-women’s bodies. Daily Maverick, 12 February 2018. Available at: https://www.dailymaverick.co.za/article/2018-02-12-health-e-news-contraception-hiv-and-control-over-black-womens-bodies/#.Wo8J66iWbIU (accessed 22 February 2018).
  2. Donovan P. Planned Parenthood whitewashing life-and-death info on HIV protection. Huffington Post, 5 February 2012. Available at: https://www.huffingtonpost.co.uk/entry/planned-parenthood-aids_b_1315840.html (accessed 31 March 2018).
  3. World Medical Association. Declaration of Lisbon, 2015. Available at: https://www.wma.net/policies-post/wma-declaration-of-lisbon-on-the-rights-of-the-patient/ (accessed 11 March 2018).
  4. Annex 2, para 94 in: Fourth World Conference on Women. Beijing Declaration and Platform for Action. United Nations, 1995. Available at: http://www.un.org/womenwatch/daw/beijing/pdf/BDPfA%20E.pdf (accessed 31 March 2018).
  5. WHO. Hormonal contraception eligibility for women at high risk of HIV. Geneva, WHO: 2017. Available at: http://apps.who.int/iris/bitstream/handle/10665/254662/WHO-RHR-17.04-eng.pdf;jsessionid=23B7607CE5D0CA009B27F965058C2119?sequence=1 (accessed 2 April 2018).
  6. Donovan P. The UN’s gag order on reproductive health. AIDS-Free World 13 February 2012. Available at: http://aids-freeworld.org/Our-Issues/Womens-Rights/The-UNs-Gag-Order-on-Reproductive-Health.aspx (accessed 2 April 2018).
  1. Spevack E. The long-term health implications of Depo-Provera. Integrative Medicine 2012; 12: 27-29. Available at: https://pdfs.semanticscholar.org/3fa9/48dfe365b053e02c62fe0e9599d8459a3b2e.pdf (accessed 2 April 2018).

 

 

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