In 2012, the World Health Organization (WHO) first released guidance for hormonal contraception and women at high risk for HIV as part of the Medical Eligibility Criteria (MEC). This guidance was developed due to a number of observational studies that showed women using progestogen-only injectable contraceptive methods may be at higher risk for acquiring HIV. As part of this guidance, WHO added a note to the MEC noting that women who are at risk for HIV should be informed of this possible increased risk and be provided access to HIV preventative methods such as condoms. In 2016, new meta-analysis available resulted in progestogen-only injectables moving from a MEC category 1 (a condition for which there is no restriction for the use of the contraceptive method) to a category 2 (a condition where the advantages of using the method generally outweigh the theoretical or proven risks) for women who are at high risk for HIV and it was emphasized that women should be counseled on this information.
The Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial was launched in 2015 to test the comparative risk of HIV acquisition among women using one of the following three contraceptive methods: DMPA (injectable), LNG Implants (Jadelle) and copper intrauterine devices (IUDs). Results of the ECHO trial are expected to be released in mid-2019. No matter the result, there is a need for high-quality communication and advocacy materials and a coordinated response among stakeholders.
Results 4 Informed Choice provides a platform to support all stakeholders impacted by this issue and by the ECHO trial results. Our mission is to connect people with knowledge and tools that can be used and adapted based on different country contexts and provide a space for partners to coordinate and share. All women deserve to be able to make an informed choice as they choose whether to adopt a contraceptive method, and which method to choose.
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