Injectable contraceptive under review

2012-05-05 16:51

South Africa’s most commonly used injectable contraceptive could be phased out and replaced with other long-term birth control methods.

The department of health is currently studying a document compiled by reproductive health experts. The experts reviewed the nation’s old contraceptive policy and made recommendations for several key revisions, particularly taking into account the high HIV prevalence.

Injectable progestins Depo-Provera and Nuristerate are the most commonly used contraceptives in South Africa.

A recent study conducted in seven African nations, including South Africa, showed there was a possible link between injectable hormonal contraceptives and an increased risk of HIV infection.

The study also showed that using Depo-Provera doubled a woman’s risk of transmitting the virus to her partner.

However, other studies among women using injectable contraceptives suggested there was no increased risk of either acquiring HIV or of transmitting it to a partner. The studies have sparked a huge global debate.

In February, the World Health Organisation convened a consultative meeting with 75 health experts to discuss these findings.

The group recommended women could continue to use hormonal contraceptives, but should be strongly advised to also always use condoms and other HIV-prevention measures.

Nations were also advised to consider the risks and benefits of continuing to use these contraceptives or withdrawing them.

The World Health Organisation also emphasised the need for nations to have a wider choice of contraceptive methods.

In South Africa, the Wits Reproductive Health and HIV Institute (WRHI) has been tasked with coordinating the revision of the contraception policy.

The health ministry’s spokesperson, Fidel Hadebe, confirmed that the draft document had been received and is being discussed by experts both within the department and external.

Said Hadebe: “This will then be dealt with at the management committee level before it gets to the (health) minister (Aaron Motsoaledi).”

Professor Helen Rees, executive director of the WRHI, said: “Although answering the question about the relationship between Depo-Provera and HIV acquisition requires more research before we can make a definitive recommendation, perhaps the time has come for us to shift to newer, lower-dose, long-acting hormonal contraceptive methods that have fewer side-effects.”

Rees said this phasing out should not be done “overnight” – doing so could increase the number of unwanted pregnancies in South Africa and increase the maternal death rate.

“It is very important that a wider range of contraceptives are made available to women before removing Depo from family planning clinics,” she said.

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