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- long-acting progestogens
- sexually transmitted infections
- reproductive health politics
- human immunodeficiency virus
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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Competing interests None.