New Study Helps Explain Link Between Birth Control Shot and Higher HIV Risk

Brigham and Women's Hospital researchers found a biological connection between DMPA and HIV risk.

Several recent studies have come to the alarming conclusion that the birth control shot—a hormonal contraceptive called medroxyprogesterone acetate, also known as Depo-Provera or DMPA—may put women at a higher risk of HIV. A new study from Brigham and Women’s Hospital (BWH) sought to find out why that is.

The researchers, who published their findings in the journal mBio, studied more than 800 HIV-negative women—some taking DMPA, some taking oral contraceptives, and some taking no contraceptives—in Uganda and Zimbabwe. By the end of the study, about 200 of those women had contracted HIV. To determine the role that DMPA played, the researchers looked for a connection between use of the birth control and immunological conditions, like vaginal infections and micro biome disruptions, that can predispose women to HIV.

After analyzing cervical swabs, they found that women on DMPA were indeed more likely to develop dangerous immunological changes. In women who had an infection like herpes, taking DMPA also seemed to suppress immune responses that could fight HIV and increase incidence of proteins that cause HIV. Women with an infection who were taking oral contraceptives also seemed to be at a higher risk of developing immunological problems.

Lead researcher Raina Fichorova, director of the Division of Genital Tract Biology at BWH, said in a statement that the study provides important information for women when choosing birth control:

“Women deserve to know more so that they can make informed choices about birth control. Our hope is to prevent the unwanted side effects of available hormonal contraceptives and improve and save millions of lives by developing new affordable tools and approaches to restore and keep the healthy vaginal microbial environment in women of reproductive age.”

While DMPA use is less common in the U.S. than it is in Africa, this study should underscore the importance of two things: Regular gynecological exams, and using condoms—no matter what type of contraception you’re on.