Summary: Hormonal contraception may increase susceptibility to HIV-1 infection.

Studies have shown possible ways in which hormonal contraception could influence a woman’s susceptibility to HIV. Hormonal contraceptives may also put women at risk for bone density loss, cervical cancer, and chlamydia.   

• According to a recent article featured in The Lancet, a study followed about 3,800 heterosexual couples (each of whom had one partner who was HIV-positive and one partner who was HIV-negative) in Africa for an average of 18 months. The purpose of the study was to examine the effects of hormonal contraception on HIV-1 transmission and infection. For 65% of the couples in the study, the woman was the HIV-infected partner. About 33% of these women reported having used hormonal contraception, as did about 20% of the women who were not infected with HIV. Furthermore, couples in the study reported to have used two types of contraception: injectable contraceptives (23%) and oral contraceptives (8%). Researchers found that women who used hormonal contraception were twice as likely as nonusers to acquire HIV. The study also reported that male partners of HIV-infected women using hormonal contraception had a higher risk of contracting HIV as well. When the researchers looked at specific types of hormonal contraception, the increases in risk were higher when it came to injectable forms of contraception (as opposed to oral forms of contraception). Previous studies have shown that hormonal contraception could influence a woman’s susceptibility to HIV by inducing hormonal changes in vaginal structure and decreasing immune function and defense against HIV-1. Furthermore, hormonal contraceptives have been shown to play a role in increased bone density loss, increased risk for cervical cancer, and an increased risk for Chlamydia. Researchers of this study urge for more counseling to women about the potential for the increased risk of HIV with hormonal contraceptive use (especially injectable forms), and the importance of dual protection with condoms in order to decrease the risk of HIV.¹

¹Use of hormonal contraceptives and risk of HIV-1 transmission: a prospective cohort study, The Lancet, October 2011