An analysis published in the journal Endocrine Reviews, the flagship publication of the Endocrine Society, revealed that the contraceptive injection depot-medroxyprogesterone acetate (DMPA) may increase the risk of contracting human immunodeficiency virus (HIV) among women from sub-Saharan Africa and other high-risk regions. A team of researchers at the University of Cape Town in South Africa and the University of Alabama at Birmingham in the United States examined various animal, cell, and biochemical research as part of the meta-analysis.

According to the research team, various human studies showed that DMPA was associated with an increased risk of HIV infection by up to 40 percent. The scientists also observed that DPMA behaves differently compared with other forms of progestin-based contraceptives. The scientists explained that the contraceptive acts like the stress hormone cortisol in the cells of the genital tract that can come in contact with HIV. This in turn elevates the risk of contracting the disease, the researchers said.

“The increased rate of HIV infection among women using DMPA contraceptive shots is likely due to multiple reasons, including decreases in immune function and the protective barrier function of the female genital tract. Studying the biology of MPA helps us understand what may be driving the increased rate of HIV infection seen in human research,” study first author Professor Janet P. Hapgood said in a News Wise report.

The expert stressed the importance of increased access to affordable contraceptive options among women living in areas with high rates of HIV infection in order to protect both at-risk patients and the general public. The professor also noted that greater access to contraceptives that use a different form of the female hormone progestin, unlike the one seen in DMPA, may mitigate the odds of HIV transmission. (Related: Tired of taking those hormone-wrecking birth control pills? There’s an app for that — and it’s just as effective, according to landmark study.)

The review was supported by the National Institutes of Health and the Canadian Institutes of Health Research.

Expert suggests replacing DMPA with safer alternatives

Study co-author Dr. Zdenek Hel also highlighted the need to improve access to safe, effective, and affordable birth control medications for women worldwide.

“We have to do everything in our power to rapidly replace DMPA with a safer alternative. The word ‘replace’ is critical; DMPA cannot just be taken off the shelves as many women would be left with no available option. Ideally, women should have access to a full range of contraceptive choices and should be informed regarding the benefits and potential dangers associated with each option,” Dr. Hel told News Medical Life Sciences online.

The researchers noted that a new formulation, called Sayana Press, was developed to counter the immunosuppressive effect of DMPA. According to the experts, the new treatment administers 31 percent less hormone through a subcutaneous administration.

Data from the Joint United Nations Program on HIV/AIDS revealed that there were 36.7 million HIV cases around the world in 2016 alone, more than 50 percent of whom live in eastern or southern Africa. Likewise, the review found that DMPA was estimated to be used by more than 50 million women around the world.  The treatment is popular in Alabama and other Southern states across the U.S., the researchers said.

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Sources include:

NewsWise.com

News-Medical.net