Does This Common Birth Control Increase Your Chance of Getting HIV?

A new petition is calling for the FDA to add a warning label to Depo-Provera, a popular injectible birth control, that states it may it increase the risk of HIV infection in women. The petition, signed by two dozen doctors and scientists, states that a two recent analyses linked Depo-Provera to an increased risk of infection among women in Africa.

Current warnings let women know that Depo-Provera does not prevent transmission of HIV, however the warning does not warn there is a link to increased risk of infection. The Centers for Disease Control and Prevention acknowledged the studies linking progestrin-only injection contraceptives, such as Depo-Provera, to HIV infections in 2012, but said then that the studies were inconclusive.

Petitioners claim however, that a meta-analysis of 28 studies now show a more firm relationship.

One study of monkeys linked a hormone in the drug to an increase in both vaginal inflammation and suppression of T-cell activation. In addition, a different study on norethisterone (another type of injectable contraceptive hormone) saw no increase in infection rates, leading the petitioners to rule out the possibility that this HIV transmission was because women on injectable contraceptives are less likely to take STI preventative measures. (That also means that norethisterone, sold under the brand names Aygestin, Micronor, Errin, Heather, and Jolivette would then seem a safer birth control option in this context.)

“We recognize that the clinical evidence for a causal link is inconclusive, as the findings are based on observation studies, which are subject to residual confounding and selection bias,” the petitioning scientists wrote. “Nevertheless, we posit that the…data to date suggest a reasonable plausible association.”

A Pfizer representative MacKay Jimeson told Law360 that basing the relationship on observational data made it impossible to conclusively draw a relationship between Depo-Provera and HIV infections.

“We are not aware of any scientific evidence demonstrating a causal relationship between use of hormonal contraceptives and an increase in HIV transmission rates,” Jimeson said.