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Birth control shot may increase risk of HIV infection

ANI  |  Washington D.C. [USA] 

A research suggests replacing of the common shot, known as DMPA, with alternative methods of as it is linked to the risk of infection.

"Human studies suggest use may raise the risk of infection in exposed women by about 40 percent," said Zdenek Hel, of the study.

"Importantly, we know that some other forms of do not show the same deleterious effect on the immune function in cell culture, small animals or human studies."

As of 2016, 36.7 million people worldwide were living with HIV, according to UNAIDS, the Joint Program on More than half of those people live in eastern or southern is the most advanced stage of the viral infection.

-- or depot--- is the predominant contraceptive in sub-Saharan Africa, administered as a shot every three months. It is estimated to be used by more than 50 million women worldwide.

In the research review, Janet P. Hapgood, Hel and Charu Kaushic examined the underlying biological mechanisms that could contribute to increased risk of for certain hormonal contraceptives but not others.

"To protect individual and public health, it is important to ensure women in areas with high rates of have access to affordable contraceptive options," Hapgood said.

"Increasing availability of contraceptives that use a form of the female hormone progestin different from the one found in could help reduce the risk of HIV transmission."

In addition to these clinical studies, the authors examined animal, cell and biochemical research on the form of progestin used in DMPA -- medroxyprogesterone acetate, or MPA. The analysis revealed MPA acts differently from other forms of progestin used in contraceptives. In the cells of the genital tract that can come in contact with HIV, MPA behaves like the stress hormone cortisol.

"The increased rate of among women using DMPA contraceptive shots is likely due to multiple reasons, including decreases in immune function and the protective barrier function of the female genital tract," Hapgood said.

"Studying the biology of MPA helps us understand what may be driving the increased rate of HIV infection seen in human research. These findings suggest other forms of should rapidly replace DMPA shots."

"Access to safe, effective and affordable is critical for women's worldwide," Hel said. "Up to 50 percent of unintended pregnancies in end in abortion, often performed in an unsafe manner. We have to do everything in our power to rapidly replace DMPA with a safer alternative. The word 'replace' is critical; DMPA cannot just be taken off the shelves as many women would be left with no available option. Ideally, women should have access to a full range of contraceptive choices and should be informed regarding the benefits and potential dangers associated with each option."

To offset the immunosuppressive effect of DMPA, a new formulation called has recently been developed that administers 31 percent less hormone via a subcutaneous administration.

In a manuscript released this week, Chelsea Polis, Ph.D., Guttmacher Institute, and Sharon Achilles, M.D., Ph.D., University of Pittsburgh, together with Hapgood and Hel, address the potential effect of reducing the dose of DMPA.

The authors conclude that, while the lower dose is likely to result in a partial reduction of the systemic concentration of the hormone shortly after delivery, it is not likely to ameliorate the overall negative impact of MPA on biological responses.

The findings have been published in the journal Endocrine Reviews.

(This story has not been edited by Business Standard staff and is auto-generated from a syndicated feed.)

First Published: Tue, January 09 2018. 09:45 IST