Category:HIV Sexual Transmission
Published on Friday, 16 January 2015 00: 00
Written by Liz Highleyman
Women who use the injectable contraceptive Depo-Provera long action had a modest but significant increase in the risk of HIV infection, according to a meta-analysis of studies published in 128 January at The Lancet Infectious Diseases. However, there was no increased risk for women using birth control pills.
A number of studies over the years have examined the possibility of hormonal contraceptive use increases the risk of HIV infection, but the results have been inconsistent, with some seeing an increased risk and others do not see the difference. The reason for this association remains unclear, but contraceptive hormones can alter the vaginal or cervical tissue or affect the local immune response.
Lauren Ralph, Nancy Padian and colleagues at the University of California at Berkeley Public Health School and colleagues conducted an existing study meta-analysis data on various hormonal contraceptives including pills birth control and depot medroxyprogesterone injectables (DMPA or Depo-Provera ) and norethisterone enanthate NET-EN).
Construction of a previous systematic review, they searched the medical literature PubMed database for articles published between December 2011 and June 2014 and abstracts presented at the International AIDS Society conference and annual conference on retroviruses and opportunistic infections (ends). The researchers identified a total of 26 relevant studies, 12 of which met their inclusion criteria, most of which were conducted in sub-Saharan Africa.
- The ten studies of Depo-Provera - involving a total of more than 39 500 women - showed evidence of an overall increase of risk for HIV infection among women using this method compared to other methods of contraception or not (pooled hazard ratio [HR] 1,40, or an increased risk of 40%).
- Looking at the 8 studies of women using Depo-Provera in the general population, the high risk of HIV was slightly lower (pool of HR 1,31, or an increase of 31%) than it was when including 2 studies of women with high-risk infection such as sex workers and women with HIV-positive partners for HIV (the variability among these studies 2 - HR 1,73 and 3,93 - was too large to calculate an estimate of the pool).
- There was no evidence of increased risk of HIV infection in ten combined studies or just pills with contraceptives oral progestin (pool of HR 1,00).
- There was no significant increase in risk seen in studies 5 norethisterone enanthate pool HR 1.10).
"Our findings show a moderate increase in the risk of HIV acquisition for all women using depot medroxyprogesterone acetate, with a smaller increase in the risk of women in the general population," the study authors concluded. "If the risk of HIV infection observed in our studies necessary to complete withdrawal depot medroxyprogesterone acetate which must be balanced in relation to the known benefits of a highly effective contraceptive."
"The moderate increase in risk observed in our study is not sufficient to justify a complete withdrawal of [Depo-Provera] for women in the general population," author Ralph said inThe LancetMedia release. "Ban [Depo-Provera] would leave many women without alternative immediate access, the contraceptive is one of the effective options. This can lead to more unwanted pregnancies, and because childbirth remains a threat to life in many developing countries could increase the overall level of deaths among women. "
On aAccompanying Comment ChristopherColvin at the University of Cape Town and Abigail Harrison Brown University School of Public Health discussed the controversy stemming from before conflicting research.
"Currently, the increasingly corridors narrow, and lit the debates about HIV and medroxyprogesterone link acetate depot have focused on, would need (translator's note, for me it is clear that it is so) a large randomized trial and controlled that should be done to better understand this relationship, "they wrote. "Like many scientific controversy, views have become hardened, personal, financial or political agendas have been suggested, and there was even intrigue in the form of escape copies of peer-reviewed articles. Both sides have raised important convincing arguments, but its nonpartisan character can weaken the quality of debate and restrict the display of the complex relationship between evidence, policy and practice. "
"The most important next steps for women around the world are looking at ways to expand contraceptive options CSPs use of women, literally belonging to control women (the muher is ten times more likely to contract HIV) and increase the uptake of other safe and effective contraceptive methods and to increase research on new contraceptive methods, especially those that protect against HIV and pregnancy, "said author
Senior Padian the News Center at UC Berkeley.
Note editor soropositivo.org.
Although I know that for many men and women of 30 the 2nd stop to use the other turn-off condom and I would recommend them to Bocage, with its "acid mood" ... Well, the fact is that contraceptidos not protect for nothing but the infection HIV to "only" mai a person, and I know that there KY and other lubricants, it costs me a lot (and I see the charts) believe that the current generation can succumb to the virus, leaving not only Brazil, but, on a global scale, all pessos living with HIV or AIDS, while mmencionar that would lead to a generation technique and logistically impractical and I wonder if I'm delirious for taking something they put in the water tank in the building I live.
THIS IS VERY SERIOUS and away from me refer the position of Cassandra of Revelation, I'm giving another warning shot (I already talked about it in the past) ... (...) ...
LJ Ralph, as McCoy, K Shiu et al. Use of hormonal contraceptives and women the risk of HIV acquisition: A Meta-Analysis of observational studies.The Lancet Infectious Diseases3099 (14): 71052-71057. 8 January 2015.
Colvin and B Harrison CJ. To broaden the debate on HIV and hormonal contraception (Review).The Lancet Infectious Diseases3099 (14): 71076. 8 January 2015.
Study supports link between injectable hormonal contraceptives and HIV risk.Lancet.Media advisory. 8 January 2014.
S Yang. Birth Control Shot Study links to moderately increased risk of HIV infection.UC Berkeley News Center. 8 January 2014.
Originally published in 16 / 01 / 15 in Vaginal Infections May Help Explain Link Between Hormonal Contraception and HIV Increased Risk and still I found relevant translate it. Claudio Souza, and Revised Mara Macedo1º on August 2016