Excuse for Depo: Lots of African women die anyways
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Even after accepting evidence that Depo increases women’s risk to get HIV by 40%, some people continue to push Depo in Africa.
This excuse overlooks several issues, including:
1. THE CHOICE BETWEEN RISKS TO GET HIV WITH DEPO OR TO DIE FROM AN UNWANTED PREGNANCY IS SOMETHING THAT SHOULD BE LEFT FOR WOMEN TO DECIDE. IT’S NOT SOMETHING FOR EXPERTS TO DEBATE AND DECIDE FOR WOMEN.
2. Compared to family planning programs that offer women a wide range of methods for birth control, programs that promote mostly Depo are likely to be less effective. In a US study, almost half of women who used Depo quit, whereas 30% quit the pill and 9% quit condoms. If women can’t find a method they like, they are less likely to practice birth control. Around the world, in countries with low population growth, no or low percentages of women use Depo. Other methods are associated with better family planning success.
3. Why assume current rates of maternal mortality in Africa? Why not emphasize cutting maternal mortality?
Given the evidence, the challenge for birth control advocates is to increase women’s access to safer options.
- Rodriquez MI, Gaffield ME, Han L, et al. Re-evaluation the possible increased risk of HIV acquisition with progestin-only injectables versus maternal mortality and life expectancy in Africa: a decision analysis. Global Health: Science and Practice 2017; 5: 581-591. Available at: http://www.ghspjournal.org/content/5/4/581 (accessed 2 April 2018).
- Daniels K, Mosher WD, Jones J. Contraceptive methods women have ever used: United States, 1982-2010. National Health Statistics Reports, no 62, 14 February 2013. Available at: https://www.cdc.gov/nchs/data/nhsr/nhsr062.pdf (accessed 2 April 2018).
- United Nations, Department of Economic and Social Affairs, Population Division (2017). World Contraceptive Use 2017 (POP/DB/CP/Rev2017). Available at: http://www.un.org/en/development/desa/population/publications/dataset/contraception/wcu2017.shtml (accessed 20 February 2018).