The Evidence for Contraceptive Options and HIV Outcomes (ECHO) Study

More than 150 million women worldwide use modern methods of contraception for family planning. By enabling women to avoid high-risk pregnancies, these contraceptive methods help prevent hundreds of thousands of maternal and infant deaths every year.

As the HIV epidemic spread, it became important to explore risk factors for HIV, including whether there was an association between use of specific contraceptives and HIV acquisition. There is evidence from observational studies that use of progestogen-only injectable methods — particularly depo-medroxyprogesterone acetate (DMPA) — is associated with an increased risk of acquiring HIV infection, but uncertainty remains about whether DMPA use actually causes increased risk.

The World Health Organization has determined that women at high risk of HIV infection may use DMPA because the benefits outweigh the possible risks, but that more research is needed. Data on whether use of contraceptive implants or IUDs affects HIV risk are also limited. Except for condoms, no contraceptive method protects against HIV or other sexually transmitted infections, and thus women at risk of HIV infection who are using contraception should also be advised to use condoms. Read more

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