Understanding birth control and HIV risk

Decades of research have examined the impact of hormonal birth control on women’s risk of HIV acquisition. Understanding if hormonal contraception increases HIV risk — and if so, by how much — is a global public health priority. A team including a UCSF Bixby Center researcher examined recent data on the issue to help inform future research and programs aimed at providing women with safe and effective options to manage their reproductive health. They found that:

  • Injectables containing the hormone DMPA are associated with an increased risk of HIV. Although recent studies suggest possible reasons for this increased risk, more research is needed.
  • Less evidence is available for injectables containing the hormone NET-EN, but NET-EN does appear safer than DMPA.
  • Oral contraceptive pills are not associated with an increased risk of HIV.
  • More research is needed into contraceptive implants, the Sayana Press, levonorgestrel-releasing intrauterine devices and NET-EN.

These findings have important implications for global reproductive health policies, programs and research. For instance, some countries with high HIV prevalence are moving away from injectables. Such a change in policy needs to be examined for the impact on women's contraceptive options and availability, method satisfaction, rates of unintended pregnancy and HIV risk. To ensure that all women have safe birth control options, researchers, policymakers and providers should sustain the recent momentum around this complex and important question.