Contraceptive pills and the popular Depo-Provera injection may lead to a higher risk of sexually active women contracting HIV/AIDS, a researcher warns.
Joan Robinson, a researcher at the Population Research Institute, or PRI, a non-profit research group that studies reproductive health programs, warns of a strong link between certain contraceptives and HIV/AIDS.
“More than 50 medical studies, to date, have investigated the association of hormonal contraceptive use and HIV/AIDS infection,” Robinson reports. “The studies show that hormonal contraceptives – the oral pill and Depo-Provera – increase almost all known risk factors for HIV, from upping a woman’s risk of infection, to increasing the replication of the HIV virus, to speeding the debilitating and deadly progression of the disease.”
Robinson contends that the connection has received almost no publicity or attention due to strong economic and ideological forces that push the pill.
She cites a number of studies, including a 2009 medical trial published in the journal AIDS that found “oral contraceptive pills and depomedroxyprogesterone acetate, DMPA [Depo-Provera], raised the risk of worsening HIV disease in Zambian women enrolled in a randomized trial of contraception methods.”
The study examined 595 HIV-positive women who were not receiving antiretroviral therapy, or ART, treatment that suppresses or stops a retrovirus such as HIV. At the trial’s beginning, HIV disease factors were similar in woman using an intrauterine device, or IUD, DMPA injections or oral contraceptive pills.
The researchers defined HIV disease progression as death or eligibility for ART. They didn’t find a significantly higher risk of death among women using oral contraceptives or DMPA than those using IUDs. However, women taking contraceptive pills had a 70 percent higher risk of becoming eligible for ART. Likewise, women taking DMPA had a 50 percent higher risk than women using IUDs.
“The International AIDS Society noted, “When the investigators looked at a combined disease progression metric of death or ART eligibility, they found about a two-thirds higher risk of progression in women taking oral contraceptive pills … than in women using IUDs.”
In another study published in the Journal of Infectious Diseases, researchers studied female sex workers attending a municipal STD clinic in Mombasa, Kenya. They found that “women who used [DMPA] had an increased incidence of HIV-1 infection. … There was a trend for an association between use of high-dose oral contraceptive pills and HIV-1 acquisition.”
The researchers noted that results of studies examining the association between hormonal contraception and HIV-1 acquisition have been “inconsistent,” and “no consensus exists regarding the influence of hormonal contraceptives on a woman’s risk of HIV-1 infection.” However, another study involving monkeys showed increased susceptibility to the simian immunodeficiency virus, or SIV, the animal retrovirus comparable to HIV, in female subjects treated with progesterone. “Fourteen of the 18 macaques treated with progesterone became infected with SIV compared with only 1 of 10 control animals,” according to the study.
Robinson suggests there is an “impressive body of scientific research demonstrating a Pill/HIV link,” and yet some dismiss the connection and cite a handful of studies and highly selective trials which claim to find “no increase in HIV risk among users of oral contraceptives and Depo-Provera.”
“The problem with many of these studies, such as Mati et al. 1995, Kapiga et al. 1998, and Sinei et al. 1996 is that they were conducted with and through ‘family planning clinics,'” she notes. “Since the chief business of these clinics is the promotion, sale and distribution of contraceptives, the possibility of bias is undeniable. Who would trust Marlboro to monitor a study on the link between cigarettes and cancer?”
Robinson contends that hormonal contraceptives increase almost all known risk factors for HIV infection.
“Studies have found that hormonal contraceptives ‘alter the microenvironment of the female’ and boost the cell count of those specific cells that HIV uses to infect and proliferate,” she wrote. “What is more, a progesterone side effect known to American women as ‘breakthrough bleeding,’ is caused when hormonal contraceptives excessively thicken the uterine lining. The large, bleeding surface of the uterus creates an ideal site for HIV infection.”
Robinson added, “Progesterone also has an immunosuppressant effect, which means that women using hormonal contraceptives have less in the way of natural defenses against HIV and other STDs.”
Three studies have also found that HIV-positive women on hormonal contraceptives are also more likely to pass HIV on to their sex partners due to increased “cervical shedding” of HIV in their bodily fluids.
“High-dose pill users were over 12 times more likely to shed the HIV virus than women not using contraception, low-dose users were almost 4 times more likely, and Depo-Provera users were 3 times more likely,” Robinson wrote.
An estimated 52 percent of unmarried women in America take a hormonal contraceptive. In the interest of lowering the birth rate, she explains, the United Nations Population Fund and the United States Agency for International Development deliver large shipments of hormonal contraceptives to Africa, Haiti and other AIDS-ravaged developing nations. She adds that international aid of hormonal contraceptives may be contributing to the spread of HIV/AIDS.
“How many lives are being lost because we continue to ship boatloads of hormonal contraceptives to a continent and to countries laboring under an HIV/AIDS pandemic?” Robinson asks. “Isn’t it time that we stopped?”