title: Contraceptive methods and risk of HIV acquisition or female-to-male transmission.
abstract: Effective family planning with modern contraception is an important intervention to prevent unintended pregnancies which also provides personal, familial, and societal benefits. Contraception is also the most cost-effective strategy to reduce the burden of mother-to-child HIV transmission for women living with HIV who wish to prevent pregnancy. There are concerns, however, that certain contraceptive methods, in particular the injectable contraceptive depot medroxyprogesterone acetate (DMPA), may increase a woman's risk of acquiring HIV or transmitting it to uninfected males. These concerns, if confirmed, could potentially have large public health implications. This paper briefly reviews the literature on use of contraception among women living with HIV or at high risk of HIV infection. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) recommendations place no restrictions on the use of hormonal contraceptive methods by women with or at high risk of HIV infection, although a clarification recommends that, given uncertainty in the current literature, women at high risk of HIV who choose progestogen-only injectable contraceptives should be informed that it may or may not increase their risk of HIV acquisition and should also be informed about and have access to HIV preventive measures, including male or female condoms.
authors.affiliation: Department of Gynecology and Obstetrics, Emory University School of Medicine, 49 Jesse Hill Jr. Drive, Atlanta, GA, 30303, USA, lbhadda@emory.edu.
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Haddad
authors.forename: Chelsea B
authors.initials: CB
authors.lastname: Polis
authors.forename: Anandi N
authors.initials: AN
authors.lastname: Sheth
authors.forename: Jennifer
authors.initials: J
authors.lastname: Brown
authors.forename: Athena P
authors.initials: AP
authors.lastname: Kourtis
authors.forename: Caroline
authors.initials: C
authors.lastname: King
authors.forename: Rana
authors.initials: R
authors.lastname: Chakraborty
authors.forename: Igho
authors.initials: I
authors.lastname: Ofotokun
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003267:Contraception / Q000379:methods*; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D018562:Disease Transmission, Infectious; D005260:Female; D006678:HIV / Q000472:pathogenicity; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data; D008297:Male; D011247:Pregnancy; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D044966:Anti-Retroviral Agents; D003278:Contraceptives, Oral, Hormonal