Invitees who attended back-to-back World Health Organization (WHO) consultations at the start of February were required to sign confidentiality agreements prohibiting them from talking about the meetings. They had to promise not to divulge anything that was said during the three days — not to colleagues, not to their networks, and especially not to journalists, who might misreport the facts. The world health body explained that journalists often exaggerate, and the UN doesn’t want to induce panic. The media will be informed when WHO holds an additional meeting of UN insiders on February 15, behind closed doors, and prepares a carefully worded public statement for release the next day.
The highly classified topic of discussion wasn’t a nuclear threat or a new virus that can kill within days. It was birth control.
WHO’s gag order is just the latest in a years-long effort by the United Nations’ AIDS apparatus to limit how much women know about possible links between HIV and injectable hormonal contraceptives. The UN appears to have forgotten that its job is not to control women’s sexual and reproductive decisions, but to inform them.
Here’s what the UN knows: In July 2011, researchers led by Renee Heffron at the University of Washington in Seattle presented findings from studies involving 3,790 sero-discordant couples (one HIV-negative and one HIV-positive partner) in east and southern Africa.1 The data compared women who had and women who had not used hormonal contraceptives during the research periods: twice as many HIV-negative hormonal contraceptive users acquired the virus. The rates of transmission from HIV-positive women to their male partners was also two times higher for users of hormonal contraceptives. (The findings focused on injectables because very few study participants took hormonal contraceptives in pill form, making the higher rates of HIV infection and transmission in that group “statistically insignificant.”)
In laypersons’ terms, hormonal contraceptives are products that adjust a woman’s hormone levels to prevent ovulation and pregnancy. In the east and southern African countries where the research was carried out, injectable hormonal contraceptives (“depot medroxyprogesterone acetate,” or DMPA) are the top choice of women who use contraceptives, and the Depo-Provera brand owned by pharmaceutical giant Pfizer, Inc. is the most widely used. Despite common side effects, popular features of the method are that one injection lasts three months, and a woman’s sex partner need not know that she is using a contraceptive.
The findings by Heffron and colleagues weren’t definitive; it would take years of additional research to determine beyond a doubt whether or not hormonal contraceptives actually double women’s risks of acquiring or transmitting HIV during unprotected sex. But the research team was concerned enough last July to say: “Our findings argue for policies to counsel women about the potential for increased HIV-1 risk with hormonal contraceptive use, especially injectable DMPA use, and the importance of dual protection with condoms to decrease HIV-1 risk.”
and GUESS WHAT ?, WHO has just declared that “hormonal contraceptives are safe to use for women with or at risk of HIV” based on the meetings discussed below.
WHO upholds guidance on hormonal contraceptive use and HIV
Geneva, 16 February 2012. WHO has concluded, on the advice of its Guidelines Review Committee, that women living with HIV or at high risk of HIV can safely continue to use hormonal contraceptives to prevent pregnancy. The recommendation follows a thorough review of evidence about links between hormonal contraceptive use and HIV acquisition.
Current WHO recommendations in the Medical eligibility criteria for contraceptive use (2009 edition) therefore remain: there are no restrictions on the use of any hormonal contraceptive method for women living with HIV or at high risk of HIV. Couples seeking to prevent both unintended pregnancy and HIV should be strongly advised to use dual protection – condoms and another effective contraceptive method, such as hormonal contraceptives.
- HIV warning to women using injectable contraception (guardian.co.uk)