Kenya: CONTRACEPTIVES DOUBLE HIV RISK

[Guest guest]

CONTRACEPTIVES DOUBLE HIV RISK

WEDNESDAY, 05 OCTOBER 2011 00:01

BY JOHN MUCHANGI

RISKY: A nurse shows one of the most widely used contraceptives.

THE most popular contraceptive in Kenya doubles the risk of women becoming

infected with HIV, a new study shows. Use of the injectable contraceptive also

increases the risk of HIV-positive women infecting their male partners. The

results present a predicament for women because injectables and the pill are

Kenya's most popular contraceptives, in part because women can keep them secret.

The study was published in the respected Lancet Infectious Diseases journal on

Monday and involved 3,800 couples from Kenya, Uganda, Tanzania, Botswana,

Rwanda, South Africa and Zambia. It was led by University of Washington but also

included researchers from Kenyatta National Hospital, University of Nairobi and

Moi University.

The study has prompted the World Health Organisation to convene a meeting next

January to consider if evidence is now strong enough to advise women against

injectable contraceptives. Two past studies showed similar results but

researchers yesterday said the current study is the strongest. " We want to make

sure that we warn when there is a real need to warn, but at the same time we

don't want to come up with a hasty judgement that would have far-reaching severe

consequences for the sexual and reproductive health of women, " said Lyn

Gaffield, an epidemiologist in the World Health Organisation's department of

reproductive health and research quoted in the New York Times.

Kenya's Ministry of Public Health says they are waiting for direction from the

WHO. There may however be a policy change to promote alternative family planning

solutions for women. Injectables have been the most popular form of

contraception in Kenya and are used by 48 percent of married women, according to

the 2008 Kenya Demographic and Health Survey.

About 16% of total users prefer the pill while women using implants account for

about 14 percent of total users. The Lancet study says that women using hormonal

contraception through injectables became infected at a rate of 6.61 per 100

person-years, compared with 3.78 for those not using them.

Transmission of HIV to men occurred at a rate of 2.61 per 100 person-years for

women using hormonal contraception compared with 1.51 for those who did not.

Researchers have been trying to explain the link between contraceptive use and

HIV infection. They said it is possible hormonal contraception causes biological

changes, such as changes to the cells that line the vagina or cervix and that

influence susceptibility to HIV.

Heffron, an epidemiologist and co-author of the study, however said

research examining whether the hormone changes genital tissue or vaginal mucous

had been inconclusive. " It could be that progestin in injectables causes

immunologic changes in the vagina and cervix or could increase the HIV's ability

to replicate, " on, senior director of clinical sciences at FHI

360, an NGO whose work includes researching the intersection of family planning

and HIV told the US media.

Researchers also found that there was more HIV in the genital fluid of those

using hormonal contraception than those who were not, which could explain why

men might have increased risk of infection from women using injectables. The

researchers also found that oral contraceptives increased risk of HIV infection

and transmission, but the number of pill users in the study was too small.

Others suggested that women on birth control often are careless in using condoms

for protection. The study however recorded condom use, thus excluding the

possibility that increased infection occurred because couples using

contraceptives were less likely to use condoms. Injectable contraceptives in

Kenya include Depo Provera. Pfizer, the US-based manufacturer of the branded

version of Depo-Provera, declined to comment to the New York Times on the study,

saying officials had not yet read it.

The study's authors however said the injectables used by the African women were

probably generic versions. Depo Provera has never been approved for use as a

contraceptive in the US. It is controversial because it reportedly can cause

heavy bleeding, weight gain, headaches, nervousness and depression.

http://www.the-star.co.ke/national/national/43112-contraceptives-double-hiv-risk

[Guest guest]

CONTRACEPTIVES DOUBLE HIV RISK

WEDNESDAY, 05 OCTOBER 2011 00:01

BY JOHN MUCHANGI

RISKY: A nurse shows one of the most widely used contraceptives.

THE most popular contraceptive in Kenya doubles the risk of women becoming

infected with HIV, a new study shows. Use of the injectable contraceptive also

increases the risk of HIV-positive women infecting their male partners. The

results present a predicament for women because injectables and the pill are

Kenya's most popular contraceptives, in part because women can keep them secret.

The study was published in the respected Lancet Infectious Diseases journal on

Monday and involved 3,800 couples from Kenya, Uganda, Tanzania, Botswana,

Rwanda, South Africa and Zambia. It was led by University of Washington but also

included researchers from Kenyatta National Hospital, University of Nairobi and

Moi University.

The study has prompted the World Health Organisation to convene a meeting next

January to consider if evidence is now strong enough to advise women against

injectable contraceptives. Two past studies showed similar results but

researchers yesterday said the current study is the strongest. " We want to make

sure that we warn when there is a real need to warn, but at the same time we

don't want to come up with a hasty judgement that would have far-reaching severe

consequences for the sexual and reproductive health of women, " said Lyn

Gaffield, an epidemiologist in the World Health Organisation's department of

reproductive health and research quoted in the New York Times.

Kenya's Ministry of Public Health says they are waiting for direction from the

WHO. There may however be a policy change to promote alternative family planning

solutions for women. Injectables have been the most popular form of

contraception in Kenya and are used by 48 percent of married women, according to

the 2008 Kenya Demographic and Health Survey.

About 16% of total users prefer the pill while women using implants account for

about 14 percent of total users. The Lancet study says that women using hormonal

contraception through injectables became infected at a rate of 6.61 per 100

person-years, compared with 3.78 for those not using them.

Transmission of HIV to men occurred at a rate of 2.61 per 100 person-years for

women using hormonal contraception compared with 1.51 for those who did not.

Researchers have been trying to explain the link between contraceptive use and

HIV infection. They said it is possible hormonal contraception causes biological

changes, such as changes to the cells that line the vagina or cervix and that

influence susceptibility to HIV.

Heffron, an epidemiologist and co-author of the study, however said

research examining whether the hormone changes genital tissue or vaginal mucous

had been inconclusive. " It could be that progestin in injectables causes

immunologic changes in the vagina and cervix or could increase the HIV's ability

to replicate, " on, senior director of clinical sciences at FHI

360, an NGO whose work includes researching the intersection of family planning

and HIV told the US media.

Researchers also found that there was more HIV in the genital fluid of those

using hormonal contraception than those who were not, which could explain why

men might have increased risk of infection from women using injectables. The

researchers also found that oral contraceptives increased risk of HIV infection

and transmission, but the number of pill users in the study was too small.

Others suggested that women on birth control often are careless in using condoms

for protection. The study however recorded condom use, thus excluding the

possibility that increased infection occurred because couples using

contraceptives were less likely to use condoms. Injectable contraceptives in

Kenya include Depo Provera. Pfizer, the US-based manufacturer of the branded

version of Depo-Provera, declined to comment to the New York Times on the study,

saying officials had not yet read it.

The study's authors however said the injectables used by the African women were

probably generic versions. Depo Provera has never been approved for use as a

contraceptive in the US. It is controversial because it reportedly can cause

heavy bleeding, weight gain, headaches, nervousness and depression.

http://www.the-star.co.ke/national/national/43112-contraceptives-double-hiv-risk