FP2020 statement on WHO guidance on hormonal contraception and HIV

Family Planning 2020 (FP2020) commends the World Health Organization (WHO) for continuing to closely monitor research and evidence and update guidance on hormonal contraception and HIV acquisition.  

The WHO released new guidance March 2, 2017 stating that women at high risk of acquiring HIV can use progestogen-only injectables, but when considering use they should receive comprehensive information and counseling on contraception and potential HIV risk.  The guidance states that women should be counseled about the association between these methods and HIV acquisition, about the uncertainty as to whether the relationship is causal, and about how to minimize their risk of HIV infection.

The new guidance modifies the WHO’s Medical eligibility criteria for contraceptive use (MEC)a critical tool for clinicians that presents current WHO recommendations on the safe use of various contraceptive methods.

Specifically, the WHO has moved progestogen-only injectables from MEC category 1, where there is no restriction for use, into MEC category 2, which is used for contraceptive methods where the advantages of use generally outweigh the theoretical or proven risks.

The WHO’s decision reinforces the efficacy of progestogen-only contraception, which includes norethisterone enanthate (NET-EN) and depot medroxyprogesterone acetate (DMPA, intramuscular or subcutaneous), and that women should not be denied the option to use these methods because of concerns about potential increased HIV risk.

At the same time, the decision underscores the critical importance of ensuring all women have the information they need to make the best choices for their health, lives, and futures.

The fundamental principle of informed choice and decision-making demands that all women—including those in vulnerable populations, such as women at high risk of HIV infection —have the ability to access accurate, clear, and easily-understood information about a variety of contraceptive methods and their use.

All service delivery, programmatic, and policy efforts must be rights-based and ensure women’s fundamental right to informed choice and decision-making and counseling free of stigma and discrimination or coercion. 

FP2020 is dedicated to ensuring that women and girls have access to a wide range of contraceptive methods and are empowered with the knowledge and tools they need to make informed decisions.

We are committed to supporting the WHO’s leadership in strengthening this much-needed knowledge base. FP2020 looks forward to working with our partners to ensure this information is clearly and accurately communicated with all stakeholders.