June 29, 2012
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CDC renews recommendation for hormonal contraception use in women with HIV

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The CDC affirmed its previous recommendations for the use of hormonal contraception among women at high risk for HIV infection or who are infected with HIV, clarifying that the data are inconclusive on the association between progestin-only injectable use and HIV acquisition.

The updated recommendations also affirm that women who do not use condoms should be counseled about the risk for sexually transmitted infections.

In 2010, the CDC first published the US Medical Eligibility Criteria for Contraceptive Use, which was adapted from the Medical Eligibility Criteria for Contraceptive Use published by WHO. WHO affirmed its recommendations in 2012 with a clarification on the use of progestin-only injectables, prompting the CDC to assess whether its recommendations should also be updated.

The CDC considered three systematic reviews conducted by WHO in its review of the evidence. When considering hormonal contraception use and the risk for HIV acquisition, there were 20 observational studies that suggest that there is no association between oral contraceptive use and risk for HIV acquisition. There was also no causal association between injectable contraception use and HIV acquisition.

There was one observational study regarding the use of hormonal contraception among women with HIV and risk for female-to-male HIV transmission. There was an increased risk for transmission with the use of injectable contraception, but not oral contraception.

To analyze the association between hormonal contraception use and the risk for HIV disease progression, there were 10 observational stories available. The evidence did not suggest an increased risk for HIV disease progression.

“Contraception is critically important to prevent unintended pregnancy among women at risk for HIV infection or infected with HIV and such women can continue to use all hormonal contraceptive methods without restriction,” the CDC researchers wrote. “However, HIV infection preventive measures, such as voluntary testing and counseling, access and adherence to ART drugs and correct and consistent use of condoms, should be strongly encouraged among all women at risk for HIV acquisition and women living with HIV infection.”

For more information:
  • CDC. MMWR. 2012;61:449-452.
Disclosure:
  • The researchers report no relevant financial disclosures.