A commonly used contraceptive, Depot Medroxyprogesterone Acetate (DMPA), may increase a women’s risk of HIV infection by 40%, according to research published in Endocrine Reviews.

The birth control injection, which is administered every three months, is a popular form of birth control in sub-Saharan Africa, a region that has a high HIV infection rate.

In the study, the authors explored the underlying reasons DMPA may increase the risk of HIV while other contraceptives do not.

Evidence suggests that this injectable contraceptive may increase the risk of HIV by up to 40%, however other forms of contraceptive injections were not found to have the same risks.

“To protect individual and public health, it is important to ensure women in areas with high rates of HIV infection have access to affordable and safe contraceptive options,” said lead author of the review from the University of Cape Town’s (UCT) Department of Molecular and Cell Biology, Professor Janet P. Hapgood.

In addition to clinical studies, the researchers examined animal, cell and biochemical research on the form of progestin used in DMPA -medroxyprogesterone acetate (MPA). The analysis revealed MPA acts differently than other forms of progestin used in contraceptives. MPA behaves like the stress hormone cortisol in the cells of the genital tract that can come in contact with HIV.

“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,” concluded Prof Hapgood.

Increasing the availability of contraceptives that use a different form of progestin than the one found in DMPA could help reduce the risk of HIV transmission.

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