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Hormone injections for birth control

Risks from hormone injections for birth control

There is a lot of evidence that hormone injections increase women’s risk for HIV. Some evidence also shows that HIV-positive women taking hormone injections are more likely to transmit to men, and that their HIV infections progress faster to AIDS. Here’s some of the evidence:

Women’s risks to get HIV — Women’s risk to transmit HIV — HIV-positive women’s risk to progress to AIDS

Heavy reliance on hormone injections in Africa

Compared to women around the world, African women rely more heavily on hormone injections for birth control. Consider the 15 countries with the worst HIV epidemics — with 5% to 26% of adults infected (see Table below). In these 15 countries, the percentage of partnered women aged 15-49 years using injected hormones for birth control in 2009 exceeded 10% in 7 countries and even 20% in 3 countries. In contrast, only 3.1% of women outside Africa used injected hormones (see last line in the Table below).

Moreover, use of injected hormones for birth control increased in the face of accumulating evidence that they increased women’s risk for HIV. From 1996 to 2009, the percentage of women using injected hormones in the 15 countries with the worst HIV epidemics increased a median of 7.4%, ranging from not more than 0.5% in Gabon to 22.6% in Malawi (see Table below).

Reliance on injected hormones may not be the best way to restrain population growth. Compared to Africa’s population growth rate of 2.5% per year, population growth in India, China, and South Korea is 1.4%, 0.5%, and 0.5% per year, respectively, with not more than 0.1% of women using injected hormones. Low rates of population growth achieved by non-African countries with minimal use of injected hormones suggest that African countries could achieve family planning goals without injected hormones.

Table: HIV prevalence, use of injected hormones for birth control, and population growth in 15 African countries with the highest adult HIV prevalence

Countries, regions % adults HIV+ Partnered women using injectable hormones Population growth (%/yr)
1996 (%) 2009 (%) 2009 (number)
Swaziland

26

5.5

17.2

20,000

1.4

Botswana

25

5.4

8.1

13,000

1.4

Lesotho

24

11.9

19.3

54,000

1

South Africa

18

19.6

28.4

1,381,000

1

Zambia

14

1

8.5

141,000

2.7

Zimbabwe

14

3.2

9.9

176,000

0

Namibia

13

7.7

21.8

42,000

1.9

Mozambique

12

ND

4.8

165,000

2.4

Malawi

11

6.4

29

633,000

3

Uganda

6.5

2.5

10.2

391,000

3.2

Kenya

6.3

7.2

21.6

1,241,000

2.6

Tanzania

5.6

4.5

10.6

724,000

2.9

Cameroon

5.3

0.4

2.3

68,000

2.2

Gabon

5.2

ND

0.5

1,000

1.9

Eq’l Guinea

5

ND

2.3

2,000

2.8

Sub-S Africa

5.0

NA

6.8

8,700,000

2.5

Rest of world

0.3

NA

3.1

32,500,000

1.0

ND: no data. NA: not available.

Sources: Injectable use by year and country from: UN, Department of Economic and Social Affairs, Population Division. World Contraceptive Use 2010; and World Contraceptive Use 2011. UN, 2011. Available at: http://www.un.org/esa/population/publications/wcu2010/Main.html and at http://www.un.org/esa/population/publications/contraceptive2011/contraceptive2011.htm (accessed 22 January 2012).

HIV prevalence from: UNAIDS. Report on the Global Epidemic 2010, available at: http://www.unaids.org/globalreport/Global_report.htm (accessed 4 July 2011).

Population growth from: UN, Department of Economic and Social Affairs, Population Division. World Population Prospects, the 2010 Revision. Available at: http://esa.un.org/unpd/wpp/Sorting-Tables/tab-sorting_population.htm (accessed 18 October 2011).


[1] Heffron R, Donnel D, Rees H, et al. Use of hormonal contraceptives and risk of HIV-1 transmission: a prospective cohort study. Lancet Infect Dis 2011; DO!:10:1016/S1473-3099(11)70247-X.

[2] Ungchusak K, Rehle T, thammapornpilap P, et al. Determinants of HIV infection among female commercial sex workers in northeastern Thailand: results from a longitudinal study. J Acquir Immune Defic Syndr 1996; 500-507.

[3] Bulterys M, Chao A, Habimana P, et al. Incident HIV-1 infection in a cohort of young women in Butare, Rwanda. AIDS 1994; 8: 1585-1591.

[4] Marx PA, Spira AI, Gettie A, et al. Progesterone implants enhance SIV vaginal transmission and early virus load. Nature Med 1996; 2: 1084-1089.

4 responses to “Hormone injections for birth control

  1. Pingback: Respecting women’s human rights by telling them about all their HIV risks « Don't Get Stuck With HIV

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