Contraception doubles risk of HIV?

A new study in The Lancet Infectious Diseases reports that the use of hormonal contraception may double the risk of HIV transmission. But, at best, what this study shows is that transmission of HIV through conventional heterosexual contact occurs rarely, if ever.

As described by the New York Times:

The study… involved 3,800 couples in Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda and Zambia. In each couple, either the man or the woman was already infected with H.I.V. Researchers followed most couples for two years, had them report their contraception methods, and tracked whether the uninfected partner contracted H.I.V. from the infected partner… The study found that women using hormonal contraception became infected at a rate of 6.61 per 100 person-years, compared with 3.78 for those not using that method. Transmission of H.I.V. to men occurred at a rate of 2.61 per 100 person-years for women using hormonal contraception compared with 1.51 for those who did not.

The Times further reports that,

The researchers recorded condom use, essentially excluding the possibility that increased infection occurred because couples using contraceptives were less likely to use condoms.

Regardless, condom use was self-reported, and so ever-dubious. It’s quite possible/likely that couples using hormonal contraception were less likely to adhere to the condom regimen. Additionally, the results were not adjusted for type of sexual activity.

As there were only 73 women who seroconverted (out of 1,314) and only 13 women who seroconverted in the hormonal contraception using group, there is certainly enough uncertainty in self-reported condom use and type of sexual activity to question the claim that hormonal contraception plays any physiological role in risk of HIV infection.

Click for the study.

4 thoughts on “Contraception doubles risk of HIV?”

  1. Splitting hairs about HIV infection pathways is like having fuses of several different lengths all tied to one block of explosive. Sooner or later, KABOOM! Convoluted research with percentages, probabilities, groups, psychology, or anything else, cannot take the H out of HIV.

    This is like looking at all the people who stomped all over Florida looking for the fountain of youth. All that was accomplished by them was to make Florida very flat.

  2. That’s a something that I can agree with. Perhaps you should consider rephrasing the “Hardly, if ever” statement to make that more clear. Perhaps I am oversensitive due to one unfortunate run-in with a “HIV doesn’t cause AIDS” campaigner back in my college days, but it makes one jump to the wrong conclusions.

  3. No one said heterosexual transmission was impossible, but ease of transmission is hardly what it was touted to be. Given the violence usually involved in rape, transmission under those circumstances is quite conceivable.

  4. I have to say I agree with your analysis that the pill connection is junk science, but could you explain the last sentence in your opening paragraph? While the increase risk of blood contact in rear-entry would cause a greater risk of infection, I don’t see how you can say that heterosexual contact doesn’t correct.

    I’m equally skeptical of your first link, if not more so, because while he has points about AIDS being overhyped and having a much lower infectivity than first feared, the claims that vaginal HIV spread is impossible is more than slightly perposterous. There are numerous instances where women were infected by rape, and the idea that you cannot spread AIDS by heterosexual sex sounds like you can’t get the flu by French kissing.

    I’ll need a lot more data to be convinced.

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