A landmark scientific trial in Japanese and southern Africa has discovered no giant difference inside the hazard for obtaining HIV amongst girls the use of any of 3 not unusual methods of birth control, but also, Johns Hopkins specialists say, showed an unacceptably high occurrence of HIV infection among girls who participated in the take a look at.
Data from the Evidence for Contraceptive Options and HIV Outcomes, or ECHO, take a look at, published nowadays in The Lancet. The journal also includes a observation at the study co-authored by way of Lisa Noguchi, director of maternal and newborn fitness for Jhpiego, a non-earnings affiliate of Johns Hopkins and a global chief in the introduction and shipping of both HIV prevention and circle of relatives making plans services in excessive HIV incidence settings.
“While ECHO has responded critical questions about threat of HIV acquisition among women searching for effective birth control, a extraordinary deal of labor stays to be executed to make sure all girls and women get hold of better included circle of relatives making plans, HIV prevention, and maternal fitness services,” Noguchi said.
Added Leslie Mancuso, Jhpiego’s president and CEO: “The look at results are specifically reassuring for women and girls at high hazard for HIV acquisition, lots of whom live in countries served through Jhpiego applications in family planning, HIV, and maternal and newborn fitness. This proof is crucial for Jhpiego workforce and health companies who take care of millions of ladies and girls at risk for HIV who depend upon or are planning to apply birth control. It additionally compels us to find extra strong methods to interact ladies and ladies of their very own fitness.”
For the trial, 7,829 sexually energetic, HIV-poor women between the ages of sixteen and 35 were randomly assigned to apply one among three fairly powerful strategies of contraception:
An anjectable depot medroxyprogesterone acetate intramuscular, or DMPA-IM
A progestin-primarily based implant containing the hormone levonorgestrel, or LNG implant
A non-hormonal copper intrauterine device, or copper IUD
Results had been announced nowadays on the South African AIDS Conference in Durban, South Africa.
The World Health Organization plans to problem steering in past due July on the clinical eligibility standards for the contraceptive techniques used within the have a look at, and Jhpiego will paintings intently with in-country partners to incorporate updated tips into exercise for frontline fitness care vendors, most of whom are nurses and midwives.
Kelly Curran, Jhpiego’s senior director for HIV and infectious sicknesses, said she welcomed the consequences of the look at however lamented the excessive fee of recent HIV infections among take a look at members.
Curran referred to that overall HIV occurrence in ECHO turned into nearly 4% in line with year, despite the reality that contributors obtained massive HIV prevention counseling. While this determine may sound low, Curran said, “if one hundred ladies are HIV bad at age 15, however four% of them accumulate HIV every year, you could see how incidence in these settings turns into sky high by age 30.
“This demonstrates that many ladies in southern and japanese Africa remain at threat and need get right of entry to to evidence-primarily based HIV prevention strategies,” she delivered.
The ECHO Study randomly assigned HIV-poor women from the Kingdom of Eswatini, Kenya, South Africa, and Zambia to use one of the three contraceptive methods. Women obtained counseling on circle of relatives making plans and HIV prevention and referral for oral PrEP, or pre-publicity prophylaxis, wherein to be had. A key impetus for the trial turned into ongoing uncertainty about whether DMPA-IM extended women’s chance of contracting HIV, a situation that has been ongoing for several decades.
Importantly, the outcomes of ECHO showed that the three methods—all utilized in countries in which Jhpiego works—are secure and powerful for preventing pregnancy.