Every package of either oral or injectable contraceptives includes a warning that they do not protect against sexually transmitted diseases including HIV/AIDS. This warning may need to be amended: A study published in the October 4 issue of The Lancet Infectious Diseases found that use of a hormonal contraceptive doubles the risk of acquiring HIV/AIDS.
Researchers from the University of Washington conducted a very extensive study of HIV transmission in African women using hormonal contraceptives. Their analysis looked at over three thousand heterosexual couples in which only one partner was positive for HIV. In couples where the woman was positive but the man was not, researchers found that men whose partners were using hormonal contraceptives were twice as likely to contract HIV/AIDS as men whose partners were not using hormonal contraceptives.
The results were similar when the researchers looked at women who did not have HIV/AIDS but whose male sexual partners did. Those women who were using hormonal contraceptives were also twice as likely to become infected as women who were not. The researchers point out that because so few women were using oral contraceptives, the increase in HIV transmission in this group was consistent with the findings in the injectable contraceptive group, but was not statistically conclusive.
There are several possible reasons for the increased HIV transmission rate associated with hormonal contraceptives. First, exposure to contraceptive hormones results in a structural change in the vaginal lining, making it thinner and prone to developing small tears. These tears increase both partner’s exposure to the virus. Second, hormonal contraceptives weaken a woman’s immune system, making her less able to repel an HIV exposure. Finally, in the UW study, the researchers confirmed that women taking hormonal contraceptives shed more HIV virus in their cervical secretions, making them more infectious.
The authors of the study found the results so convincing that they recommended all women should be counseled about the risks of HIV infection and transmission before they are given hormonal contraceptives.
This important study further calls into question the Department of Health and Human Services’ (HHS) decision to require all insurance plans to cover hormonal contraceptives as preventive care. The mandate, which was based on a recommendation made by the Institute of Medicine (IOM), is already very controversial in many quarters due to its lack of conscience protections for employers, insurers and medical professionals. Additionally, the mandate treats the normal healthy conditions of pregnancy and fertility as diseases to be prevented and disrupted. Finally, both the IOM and the HHS willingly put the health of American women at risk by glossing over the significant risks of cancer, blood clots, and strokes associated with hormonal contraception. There is credible evidence that these inexplicable policy decisions are driven by an ideological bias rather than by sound medical practice.
If the HHS goes forward with its plan to require coverage of hormonal contraceptives, it will be mandating the coverage of drugs that prevent no disease, and are increasingly associated with cancer and vascular disease. Add to these concerns this new study’s findings of a 100 percent increased risk of HIV and AIDS transmission, and it becomes impossible to logically argue that hormonal contraception is preventive care.
Whatever the HHS’s true intentions in continuing to move forward with full implementation of the contraceptive mandate by August 2012, it hardly seems like improving women’s health is the goal.