Do hormonal contraceptives affect women’s susceptibility to HIV?

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Evidence has emerged suggesting a link between certain hormonal contraceptives and HIV acquisition risk. We present a review of the epidemiologic studies and potential biologic mechanisms evaluating the association between hormonal contraceptive methods and HIV risk. Further, we comment on current and future research efforts, overview the updated WHO recommendations and discuss the public health and ethical implications of policies to reduce contraceptive access. Many gaps remain that limit our ability to make causal conclusions about this question. Women at high risk for HIV should be offered access to all contraceptive methods; counseled on the potential increased risk with certain methods, specifically depot medroxyprogesterone acetate (DMPA); and dual method use of condoms combined with a more effective contraceptive should be encouraged.

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