Based on a study in the Lancet, the WHO has updated the medical eligibility guidelines for women at high risk for HIV. This high-quality RCT (see data below), found no difference in HIV acquisition among women who used DMPA-IM, Cu-IUDs or LNG implants. In previous guidance, DMPA-IM was Medical Eligibility Criteria (MEC) risk category 2 (advantages generally outweigh theoretical or proven risks) for women at high risk for HIV. Now with the addition of this latest evidence, WHO recommends DMPA-IM should be considered MEC risk category 1.
Combined Hormonal Contraceptive Methods
A woman’s risk of HIV does not restrict her contraceptive choice
Efforts to expand contraceptive method options and ensure full and equitable access to family planning services must continue
A renewed emphasis on HIV/STI testing and prevention services is urgently needed, including the integration of family planning and HIV/STI services as appropriate, along with sexual and reproductive health packages
Note: Other studies were also reviewed prior to release of this MEC update
HIV incidence among women using intramuscular depot medroxyprogesterone acetate, a copper intrauterine device, or a levonorgestrel implant for contraception: a randomised, multicentre, open-label trial (Lancet)
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