Pathfinder Supports WHO Guidance on Hormonal Contraceptives and HIV

Today the World Health Organization released their much-anticipated < a href="http://www.who.int/reproductivehealth/topics/family_planning/hc_hiv/en/index.html">recommendations on hormonal contraceptives and HIV. The WHO upheld previous guidance, concluding that women living with HIV, or at high risk of HIV, can safely continue to use hormonal contraceptives to prevent pregnancy. These recommendations follow concerns raised this past fall by a study that indicated a possible link between hormonal contraceptives and HIV transmission.

"This is excellent news for many women living with HIV or at risk of HIV who have been using hormonal contraceptives. We appreciate that the WHO statement explicitly acknowledges the importance of hormonal contraception," Pathfinder President Purnima Mane said. "This statement affirms the critical value of contraceptives to maternal and child health, as well as to global health and economic, and social well-being of women."

Following the study's publication in October 2011, many sexual and reproductive health experts expressed a desire for greater discussion of the findings. In January, WHO convened a technical consultation of 75 experts from 18 countries, including Pathfinder's Ton van der Velden, MD, MPH. These experts provided input and perspective for recommendations regarding hormonal contraceptive usage by HIV positive women or by those at risk for HIV. The recommendations put forth were approved by WHO's Guidelines Review Committee yesterday.

Pathfinder was pleased to participate in the consultation and supports WHO's position not to change its current recommendations in the Medical eligibility criteria for contraceptive use. WHO states, "there are no restrictions on the use of any hormonal contraceptive method for women living with HIV or at high risk of HIV." Couples seeking to prevent both unintended pregnancy and HIV should be advised to use dual methods: condoms and another effective contraceptive method, such as hormonal contraceptives.

Pathfinder's medical advisors have been following this issue closely since the study first emerged, weighing the impact of the study on public perceptions, medical interventions, and community health.

"Ongoing research on hormonal contraceptives and HIV is important for Pathfinder's work and the women we serve," Senior Advisor on HIV, Alden Nouga, said. "But right now, we're happy that results show there isn't a clear conclusion to be made about the interaction between hormonal contraception and HIV risk. What we do know is positive: hormonal contraception improves the health and well-being of women and families across the globe particularly those that are often marginalized. The WHO recommendations reflect that the outcome reported in the Heffron study could well be due to other factors."

Pathfinder will continue to work closely with local partners to ensure that the communities we support receive accurate information about family planning and HIV transmission and acquisition so that all women and men can make informed decisions about their sexual and reproductive health.

"This is a complex issue," Ton van der Velden said. "We're glad the WHO weighed in the way it did. And we look forward to continuing to support healthy outcomes for women and men in the communities we serve."

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