Dr. Renee Heffron, co-director of our Global WACh Family Planning Working Group, has received new funding from the NIH to tie into the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Study. ECHO enrolls participants in sub-Saharan Africa for a randomized trial of three equally safe and effective contraceptive methods: the copper T intrauterine device (IUD); injectable depo-medroxyprogesterone acetate (DMPA), also known as the Depo shot; and the Jadelle implant.
For sub-Saharan African women at risk for becoming infected with HIV, it is important to build knowledge around potential associations of specific contraceptives with HIV acquisition. A number of observational studies have examined whether or not use of hormonal methods affects the risk of HIV acquisition. Some of these studies suggest that injectable methods—particularly the Depo shot—might increase a woman’s risk of acquiring HIV infection, while other studies show no association. The World Health Organization continuously reviews the information about contraceptives and, thus far, has determined that all of the contraceptives that will be used in the ECHO Study are safe for women at risk of HIV risk infection, but that more research is needed.
With this additional funding, ECHO will now begin to measure biological markers periodically over the three-year trial period associated with the Depo shot, the Jadelle implant, and the copper IUD. These markers include vaginal microbiome, markers of inflammation, HIV target cells, protein signatures, and transcriptome to identify differences between women using the different contraceptives.