ECHO study finds contraception does not increase HIV risk

Marie Stopes International (MSI) welcomes a landmark study released today that finds certain contraceptive methods do not increase a woman’s risk of HIV.

The ECHO study is a rigorous international study that examined rates of new HIV infection among women using three different contraceptive methods: a hormonal injectable called DMPA, a hormonal implant called Jadelle and the non-hormonal copper IUD. The study took place in Eastern and Southern Africa, where women are hard-hit both by HIV and deaths related to pregnancy, childbirth and unsafe abortion.

The ECHO study found similar HIV incidence rates among all three methods – meaning that, when compared to each other, none of the methods significantly increases a woman’s risk of HIV. The study also found that all three contraceptive methods are safe and highly effective at preventing unintended pregnancies: reinforcing that women everywhere need access to all contraceptive methods, complemented by all available HIV prevention options.

“We welcome the release of the ECHO study, which provides crucial answers for women so they can make the best choices for their lives,” said Dr Kathryn Church, Director of Global Evidence at MSI. “Every woman, everywhere, deserves to know all the potential benefits and risks when choosing her contraception. We can now reassure them that these contraceptive methods are safe, effective and do not put them at an increased risk of HIV.”

More than 150 million women worldwide use various hormonal contraceptives to prevent an unintended pregnancy. In sub-Saharan Africa, injectable contraceptives with the hormone progestogen, like DMPA, are the most commonly used methods. Many women choose injectable contraceptives because they are often the most discreet methods available.

Given the widespread use of DMPA in areas with high HIV incidence, largely in Eastern and Southern Africa, the question of whether DMPA increases women’s risk of HIV has been a critical issue for individual women, their families and communities, and public health.

Now that ECHO has provided clear evidence that these contraceptive methods do not increase a woman’s HIV risk, MSI will continue to provide as many contraceptive options as possible for women around the world. We will also provide our clients with the information and counseling they need, reassuring them that these methods are safe and effective choices to prevent an unintended pregnancy.

“We remain committed to providing women with as many safe and effective contraceptive options as possible,” Church said. “Ultimately, the ECHO study reinforces that we must continue to prioritise the individual needs of each and every woman who comes to us for contraception. We strive to understand her personal lifestyle and needs, giving her information and counselling so she can make the choice that’s best for her.”

The ECHO study also emphasizes the urgent need for high-quality healthcare for women, including a wide choice of contraceptive methods and all available HIV prevention options. Women and adolescent girls unquestionably deserve healthily and happy lives, and they want protection from both HIV and unintended pregnancies.

“Women in Uganda, and around the world, need more choice and control over their health and lives. We can - and must - expand women’s options to prevent unintended pregnancies and HIV” said Dr. Carole Sekimpi, Country Program Director for MSI in Uganda.

“Women and girls need protection against both HIV and unintended pregnancies: they do not separate their healthcare decisions into different, distinct categories. We owe it to these women and girls – vulnerable to unintended pregnancies, unsafe abortions and HIV - to provide them with respectful, holistic and personalised healthcare that focuses on their unique lives and needs.”

Sekimpi added: “In Uganda and globally, every woman and adolescent girl needs more safe and effective contraceptive options, HIV prevention methods and healthcare that prioritises her needs and desires, as well as the knowledge to help her make informed decisions.

“Women and girls everywhere deserve the opportunity to make their own choices and determine their own futures.”