Contraceptives that Increase Chances of Getting Infected by HIV

I guess we all know that if you have unprotected sex with a person who is positive its not a given that you will get it, theres a chance you wont, also that women are at higher risk bcz a higher surface area is exposed to the seminal fluids. Research already shows that the pill -oral contraceptive is a class 1 carcinogen like asbestos meaning it has high chances of giving a woman cancer but now depo provera used by 48% of women has been linked to higher rates of HIV acquisition. This was discovered awhile back in the west but KEMRI has been recently researching it and found a positive correlation.

A recent meta-analysis, Brind, et al. (2015), conducted in collaboration with the Population Research Institute, found that the associated risk of acquiring HIV with DMPA usage was significantly higher than for women who did not use DMPA based injectable contraceptives. DMPA was found to increase women’s risk of contracting HIV by 49% compared to women not using steriodal (hormonal) contraceptives (HR = 1.49, 95% CI 1.28-1.73). Over 88% of cross-sectional studies and over 75% of longitudinal studies observed a positive association between HIV acquisition and DMPA use.

These findings were confirmed in earlier, less precise studies comparing the risk of DMPA compared to the general population. Less precise non-prospective studies found that DMPA increased the risk of HIV transmission by over 40% (OR=1.41, 95% CI 1.15-1.73).

These findings are confirmed in two other meta-analyses published that were also published in 2015. Ralph, et al. (2015) in Lancet Infectious Diseases found a pooled hazard ratio of 1.40, 95% CI 1.16-1.69 among DMPA users. Morrison, et al. (2015) in PLoS Medicine also found similar results with an adjusted hazard ratio of 1.50, 95% CI 1.24-1.83 for DMPA. All three meta-analyses found that the risk of acquiring HIV with DMPA is 40-50% higher than the comparison group.

Researchers are not entirely certain why women who use DMPA injectables contract HIV at higher rates than the general population. A number of likely mechanisms of action have been proposed.

DMPA is an artificial steroid made to mimic the effects of natural endogenous progesterone, a hormone that helps regulate the menstrual cycle and is crucial during pregnancy for the health of the fetus. One of the effects of progesterone is to attenuate the immune system’s inflammatory response to allow the body to accept the embryo during pregnancy. This attenuation of the immune system could also make it easier for the HIV virus to cause an infection.

Studies have shown that, unlike endogenous progesterone, DMPA has an affinity not only for the progesterone receptor, but also the glucocorticoid receptor (GR) and the androgen receptor.ii MPA has been found to mediate the upregulation or downregulation of various pro-inflammatory and anti-inflammatory cytokines and chemokines through, as some studies have found, MPA’s affinity for the GR.iii

One study found that, in the presence of concentrations of MPA in similar to serum levels of MPA found in women after receiving a DMPA injection, MPA significantly increases transcytosis of HIV across genital epithelial cells in vitro.iv Epithelial layers in the genital tract are crucial preventing the HIV virus from reaching stromal tissues where active infection of target leukocytes such as CD4+ T cells and macrophages is easily effected. T cells cultured in epithelial cells challenged with a CRCX4-tropic strain of HIV and treated with MPA have been observed in vitro to produce significantly higher levels of HIV viral replication than estradiol treated cells.v

samali pliss,weka jina ya contraceptives ------------>{hapa}

The last bio I did was in Form 4 so am abit rusty but lemme try to explain in lay woman’s lingo

The contraceptive depo prevera (DMPA ile injection watu huweka I think upto 5 years? )is a progestrone based one, I believe the pill is an estrogen based one, though sijui bcz Ive never used contraceptives. So kuna cells which cover various areas like skin,urinary and genital even digestive tract? they’re called epithelial cells, so their work is to act as a barrier ndio germs/bacteria/viruses dont get access to where they can replicate and cause infection and attack redcells and or white blood cells by reaching the connective tissue(stromal cells) ndio inaitwa transcytosis(kuvuka border across the barriers till they get into the T-Cells and attack , now steroids deter inflammation , but inflammation helps to keep off any virus,or bacteria or protozoa( za malaria ni protozoa ama ni bilhazia tuu?) or incase of allergy dust , so these guys used 2 different steroids on the cells of the control groups , one wasone with progestrone(DMPA) the other was one with estrogen(estradiol) so progestrone is produced by the body when a woman gets pg to lower the chances of the white blood attacking the embryo the way they attack anything foreign in the system, I think its how blood cancers happen, the body starts attacking itself because the bad guys mimic the good guys or how implants like kidney or heart transplants are rejected. So in this form the immune system is supressed by the progestrone based steroid, so Ukedu inaingia mwendo wa aste aste like Kenyan atheletes crossing the winning line.

i knew it :D,

The group of women who use DEPO already have a higher than average risk of contracting HIV (age, sexual habits, marital status, etc.). Most live in rural areas. DEPO should be banned. Those 50 bob a shot injections that offer contraception for 3-6 months are doing a lot of harm to Kenyan women.

Thing is that’s what they can afford and what is most convenient bcz swallowing pills every day is alot for these busy women.

What of the one women put in the upper arm like a biro tube and it lasts 5 years. Ive also seen that IUD does quite a bit of damage, there were 3 types of contraceptives being researched but the DEPO was the worst - 40-50% is crazy high.

Access to these articles, I can still get them, but kama uko nazo especially the Kemri one I would appreciate. First the studies were not prospective which means the researchers may not have effectively controlled for confounding factors. 49% sounds high but it should be remembered it’s a risk not causation.