Friday, October 21, 2011

Family Planning groups Spreading HIV/AIDS in Africa through hormonal contraception?

According to recent reports the most widely used contraceptive in sub Saharan Africa doubles the risk of transmission of HIV. This result is clearly indicated in a scientific research study, conducted by an international team, funded by the Bill & Melinda Gates Foundation, which was published on October 4th in the "The Lancet".  

The study, which related to 3,790 couples in which one partner was HIV positive, was conducted over a two-year period with quarterly clinical trials.  The couples were selected from 8 African countries with high HIV rates, Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda and Zambia.
The results of this scientific study are clear: where one partner in a couple is HIV positive, the use by the woman of the hormonal contraceptive Depo-Provera - produced by the pharmaceutical company Pfizer and administered by injection, doubles the risk of infection of the healthy partner: the percentage of women infected rose from 3.78 to 6.61% in a year, while for men the probability of infection is raised from 1.51 to 2.61%.

This study is not the first to make the connection between Depo-Provera and increased HIV rates. A 2004 study by the National Institutes of Health, University of North Carolina and Johns Hopkins University in Baltimore (Morrison et al) found that the use of injected hormonal contraceptives increases the risk of STD’s. see report
Depo-Provera use is widespread in Africa, due to its convenience: it is taken quarterly and does not need the assistance of a doctor. It is estimated that about 12 million African women between 15 and 49 years (6 percent) use this method of contraception.

Shockingly despite the earlier studies WHO and other associated groups including UNFPA, UNDP and the World Bank issued the following statement. 

WHO's systematic review of the evidence on whether use of hormonal contraception modifies the risk of acquiring a STI was updated.  It was reviewed by the WHO Family Planning Guideline Steering Group who concluded that this new evidence does not modify the current guidance, namely: there are no restrictions on the use of COCs and DMPA by women at high risk of acquiring a STI 

Once again despite tthe clarity the results in the current research it appears that for ideological reasons international organizations such as the United Nations Population Fund (UNFPA) and the World Health Organisation (WHO) are once again failing in their duty to take this into account and continue to allow the drug to be administered to African women, despite the apparent risks. Women's health in third world countries appears to be secondary to ideology in the priorities of these organisations, under the pretence of reducing maternal mortality the priority of international organizations is to reduce the number of children women bear rather than making pregnancy and childbearing safer for women.

The WHO instead of acting immediately to save lives by issuing a statement for women to cease using hormonal contraception it has instead issued a statement, which casts doubt on the results of the study and has arranged a meeting to discuss the issues early next year. The WHO statement reads:

“Currently, systematic reviews conclude that the weight of evidence does not indicate that use of hormonal contraception increases the risk of HIV acquisition, transmission or disease progression among the general population, but may have an impact on women at high risk of HIV infection, such as sex workers."

The statement continues 

"[…] WHO and partners have urged for more research to resolve key gaps in our understanding of the topic.  In light of the study by Heffron and colleagues, as well as the public health concerns it raises, WHO is convening a Technical Consultation on 31 January - 1 February 2012 to re-examine the totality of evidence on potential effects of hormonal contraception on HIV acquisition, disease progression, and infectivity/transmission to sexual partners.”