The World Health Organisation (WHO) has agreed that a woman’s risk of HIV should not restrict her contraceptive choice. This was contained in the organisation’s updated recommendations for contraceptive eligibility for women at high risk of HIV.
The new updates were attributed to the results of the ECHO trial that demonstrated no statistically significant differences in HIV acquisition among women using intramuscular depot medroxyprogesterone acetate (DMPA-IM), copper intrauterine devices (Cu-IUDs), and levonorgestrel (LNG) implants.
“This high-quality evidence superseded the low to low-moderate quality observational evidence previously available,” WHO stated.
Contraceptive-eligibility-for-women-at-high-risk-of-HIV“Evidence shows that a woman’s risk of HIV should not restrict her contraceptive choice,” said Dr Peter Salama, Executive Director, Universal Health Coverage/Life Course at WHO. “All women should have access to a wide range of options for contraception as well as to HIV prevention and to treatment if needed.”
The updated recommendations to the WHO guideline, Medical eligibility criteria for contraceptive use, stem from a review of the latest evidence conducted by the independent Guideline Development Group convened to inform WHO. This Group assessed all of the evidence on hormonal contraception and risk of HIV acquisition published since the previous review published in 2016, along with a systematic review of all published evidence on copper-bearing IUDs and HIV risk.
The global recommendations have particular bearing for sub-Saharan Africa, which has the highest rates of HIV transmission but also some of the biggest challenges in ensuring women have access to a full range of contraceptive options. Currently a quarter of women aged 15–49 in Africa (24%), who want to delay or prevent having children, have limited access to modern contraception. This is the highest unmet need across all WHO regions.