The HIV Prevention Trials Network congratulates the Evidence for Contraceptive Options and HIV Outcomes (ECHO) research consortium, led by FHI 360, the University of Washington, Wits Reproductive Health and HIV Institute (Wits RHI) and the World Health Organization (WHO), for conducting this rigorous study and providing high-quality scientific evidence to the fields of contraceptives and HIV prevention research.
A total of 7,829 African women between ages of 16 and 35 years old from Eswatini, Kenya, South Africa and Zambia were randomly assigned to use one of three highly effective methods of contraception [the progestin-only depot-medroxyprogesterone acetate, given by intramuscular injection (DMPA-IM); a non-hormonal copper intrauterine device (copper IUD); and a progestin-based implant containing the hormone levonorgestrel (LNG implant)]. The study aimed to determine whether any of these contraceptive methods were associated with higher rates of HIV acquisition. The results of the study were released on June 13, 2019 at the South African AIDS Conference in Durban, South Africa. The findings showed no substantial difference in HIV incidence across the three contraceptive study arms with high contraception effectiveness.
Demonstrating that the use of DMPA-IM does not increase the risk of HIV infection among women is reassuring, especially because it is a widely used modern method of contraception for millions of women in sub-Saharan Africa. The results from the ECHO study provide reassuring data on other contraceptive options for these women.
Although there was no substantial difference in HIV risk among the three methods of contraception in ECHO, the overall HIV incidence was high (3.81 %). This demonstrates the urgency of highlighting HIV prevention, particularly use of pre-exposure prophylaxis among these women.