Study reveals link between contraception and STI risk

Sunday, January 19th, 2020 23:24 | By
Nelly Mugo, head of Sexual, Reproductive, Adolescent And Child Health Research Programme at Kemri.

There has been debate on whether women in long-acting contraceptives have a higher risk of HIV infection and whether the risk differs with use of different methods.

A new study appears to settle this debate, after it found no link between HIV infection and contraceptive methods.

However, The Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial indicated that women on reversible contraception have recorded higher rates of sexually transmitted infection compared to the general population.

Echo, conducted in four different countries in Africa, including Eswatini, Kenya, South Africa and Zambia, showed there was 40 per cent new infection of HIV among women in the country as compared to men.

It further reveals Chlamydia and treated gonorrhea were among Sexually Transmitted Infections (STIs) contracted by women on modern family planning.

Inadequate counselling

ECHO trial is a three-arm study in which 7,829 sexually active HIV negative women, aged 16-35 years across 12 clinical trial sites from the four countries, were randomly assigned one of three contraceptive methods: Jadelle implant, the copper intrauterine device (IUD) or Depo provera (DMPA_IM) or levonorgestrel (LNG) implant. 

The Aids Vaccination Advocacy Coalition (AVAC) said the trial measured and compared rates of HIV among women in the trial.

In Kenya, about 900 women in Kisumu took part in the study, locally coordinated by Kenya Medical Research Institute (Kemri).

The highly publicised trial found that Depo was associated with 30 per cent lower risk of gonorrhea infection compared to the IUD and 20 per cent lower risk of chlamydia infection. 

Women on Depo had a significantly lower risk of gonorrhea and chlamydia infections compared to women who used the hormonal implant or IUD.

These findings are significant since initially, there had been no clinical trials that captured the relationship between STI risks and contraception.

 “Studies had examined whether hormonal implants or IUDs affected users’ risk of HIV infection,” said Nelly Mugo, head of Sexual, Reproductive, Adolescent And Child Health Research Programme at Kemri.

She adds that the major problem in trying to establish a way to fight STI in inadequate counseling offered to women trying to access contraceptives. 

“The problem is anytime a woman might want to access contraceptive, there is a lot of stigma. That just builds up to our inability to treat these diseases,” says Mugo.

She adds there needs to be an integrated and comprehensive care, meaning everyone needs to get quality contraceptive counselling on STI and screening of HIV in the same area for it to be easier to cater for both at the same time, especially in family planning facilities.

-Sandra Wekesa

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