WHO revises Depo Provera guidelines

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The World Health Organisation (WHO) has revised guidelines on Depo Provera use by women at high risk of acquiring HIV, following evidence from a study which showed that there was no link between increased HIV risk and use of contraceptives.

The new guidelines now emphasise on correct and consistent use of condoms and pre-exposure prophylaxis (PrEP) by women at high risk of contracting HIV or in settings where HIV prevalence is high.

“Evidence shows that a woman’s risk of HIV should not restrict her contraceptive choice,” said Dr Peter Salama, executive director, Universal Health Coverage/Life Course at WHO.

“All women should have access to a wide range of options for contraception as well as to HIV prevention and to treatment if needed.”

Since there was no study proving or disapproving the link between HIV risk and use of Depo Provera, WHO has been carefully making recommendations depending on available evidence over the past 20 years.

In 2014, WHO guidelines permitted use of all hormonal contraceptives, but with a disclaimer that progesterone-only injectable contraceptives, which include Depo Provera may or may not increase one’s risk of HIV acquisition.

Progesterone-only injectable contraceptives are a form of hormonal contraception and progesterone-only contraception that are administered by injection and providing long-lasting birth control.

The 2014 guidelines further encouraged HIV preventive measures, including male and female condoms in women at high risk of HIV infection.

In 2017, WHO released revised guidelines on the use of the same contraceptives from which it stated that the advantages of using them generally outweighed the “possible, but unproven”, increased risk of HIV acquisition.

Early this year, researchers released results of a four-year study, which showed no link between increased HIV risk and use of hormonal contraceptives, ending years of uncertainty in use of these contraceptives.

The debate on Depo Provera increasing the risk of HIV acquisition started in 1996 when scientists discovered that monkeys injected with high concentration levels of Depo Provera had their biological make-up weakening, thereby allowing easy penetration of SIV, an equivalent of HIV in humans, into their system.

Since then, there has been unproven talk that Depo Provera increased risk of HIV acquisition.

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