Ongoing debates over injectable contraceptives for HIV prevention, and the idea that there is an increased risk of contracting HIV when using such, have been escalating. Researchers have found their studies inconclusive – some reports show that risk increases and some claim that it does not. So why the discrepancies, and what is the biological reason for such findings?

To start, the contraceptive being accused of aiding the transmission of HIV is known as Depo-Provera or DMPA. Reports that it increases the risk for HIV infection are growing, yet studies come up with data that is contradictory. To determine the real risk, along with an explanation, a thorough investigation was made. Over 800 women were analyzed. All started out HIV free and were enrolled in family planning clinics. The women were divided into three groups. One group used oral contraceptives, the other DMPA, and the final group did not use hormonal contraceptives. Later, 200 of the participants became infected with HIV. A look at the vaginal flora of the women within each group gave researchers the explanation they had been searching for.

For each group, there were those with a healthy vaginal environment and those with infections from either parasites, bacteria, or fungi. Further, it was confirmed that those taking the DMPA contraceptive presented with more changes to the immune system, which meant more vaginal infections, increased inflammation, and an increased risk of contracting HIV. The compromised vaginal state proved a poor resistor to infection, including contracting HIV. Certain protein levels are known to attract and aid HIV in spreading. However, the results of this study also showed that certain oral contraceptives could alter the immune system or suppress it. This too can lead to environmental changes within the vagina that can lead to easier transmission of HIV.

It is the hope of those researchers that the information from this study will move institutions to educate their patients and their partners. That way individuals can make informed choices about the types of contraceptives they decide to use, especially for HIV prevention. Thus, spread of HIV can be slowed and hopefully, in many cases, prevented.