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Letters to the editor
Human rights and clinical ethics are the right framework to address the probable DMPA-HIV interaction
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  1. Elana Covshoff, MA
  1. Ulrike Sauer, MFSRH
  1. Rudiger Pittrof, * MSc
  1. Health Improvement Practitioner, Guys and St Thomas’ Foundation Trust – Community Services, London, UK; elanacovshoff@gmail.com
  2. Consultant in Sexual and Reproductive Health, Margaret Pyke Centre, Reproductive Health, London, UK; ulrike.sauer@nhs.net
  3. Consultant in Community Sexual Health and HIV, GSTT – Sexual Health, St Thomas’ Hospital, London, UK; Rudiger.Pittrof@gstt.nhs.uk
  1. *Corresponding author.

https://doi.org/10.1136/jfprhc-2015-101176

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    We were delighted to read the very timely paper by Haddad et al.1 that has become even more topical with the recent publication of a systematic review showing that depot medroxyprogesterone acetate (DMPA) use is indeed associated with about a 40% increased risk of HIV acquisition (12 studies involving more than 39 500 women, pooled hazard ratio 1·40, 95% confidence interval 1.16–1.69).2 Other forms of hormonal contraception do not appear to increase this risk. In the accompanying press release the lead author, Lauren Ralph, stated: “Banning DMPA would leave many women without immediate access to alternative, effective contraceptive options. This is likely to lead to more unintended pregnancies, and because childbirth remains life-threatening in many developing countries, could …

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