Experts probe Depo Provera's link to higher HIV infections

Kenyans will soon know if injectable contraceptives put women at a higher risk of contracting HIV.

Researchers have completed investigations in Kisumu and will release the results mid this year, study coordinator Imeldah Wakhungu has said.

She said they probed the high HIV prevalence rates among women using the Depo Provera injectable contraception compared to those on two other methods.

“There is confusing data about whether there is a link between using some contraceptives and an increased risk of contracting HIV,” Wakhungu told journalists in Nairobi on Thursday.

Some researchers say if the link is confirmed, young women could be discouraged from using Depo-Provera.

Injectables are the most popular contraceptives in Kenya, used by about two million women (48 per cent of women on birth control).

Past studies particularly suggested the popular Depo-Provera could double the risk of a woman getting HIV or passing it to an HIV-negative partner.

Wakhungu said researchers in Kisumu were looking into whether ingredients in the drug make women’s bodies vulnerable to infection, or it has to do with the sexual behavior of its users.

“For over 25 years, the world has lived with the uncertainty about whether or not use of hormonal contraceptives increases HIV risk. The study aims to answer this critical public health question,” Wakhungu said.

The Kisumu study centre is part of the Evidence for Contraceptive Options and HIV Outcomes (Echo) study which followed a total of 7,830 women using contraceptives in Kenya, South Africa, Zambia and eSwatini for three years.

The Kenya Medical Research Institute has been coordinating the study in Kenya, alongside the University of Washington and the World Health Organisation.

Wakhungu said HIV-negative participants were randomly assigned to use any of the three contraceptive methods: Depo-Provera (injectable), the implant and the intrauterine device.

"The study will assess whether the risk of acquiring HIV is different with the use of Depo, Implants and the IUD," she said.

Coordinator of the WHO's human reproduction team Dr James Kiarie recently said the organisation recommends women at high risk of HIV infection to continue using Depo as the organisation awaits Echo results.

Dr Elizabeth Bukusi, a chief research officer at Kemri and the principal investigator at Kisumu, recently said Depo is popular in Kenya because it is convenient and women only need a jab once every three months.

Experts say even if the study links Depo to higher HIV risk, it is unlikely to be withdrawn without a viable replacement.

While there would be 49 fewer HIV infections per 100,000 women in Kenya, the decreased use of contraception by women living with HIV would result in 35 additional HIV infections in infants per 100,000 women.

“So overall there would only be 14 fewer HIV infections a year per 100,000,” according to ‘Re-evaluating the possible increased risk of HIV acquisition with progestin-only injectables versus maternal mortality and life expectancy in Africa’, a study published last December in the Global Health: Science and Practice journal.