Changes to the World Health Organization guideline on hormonal contraceptive eligibility for women at high risk of HIV: South African perspective and response

The World Health Organization (WHO) published guidelines for hormonal contraceptive eligibility for women at high risk of HIV in March 2017. This guidance followed from a technical consultative meeting convened by the WHO in December 2016, where all the available evidence on hormonal contraceptives...

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Main Authors: Z Nene, G Hofmeyr, M Patel, M Panday, H Rees, M Makua, Y Pillay
Format: Article
Language:English
Published: South African Medical Association 2018-07-01
Series:South African Medical Journal
Online Access:http://www.samj.org.za/index.php/samj/article/download/12364/8556
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author Z Nene
G Hofmeyr
M Patel
M Panday
H Rees
M Makua
Y Pillay
author_facet Z Nene
G Hofmeyr
M Patel
M Panday
H Rees
M Makua
Y Pillay
author_sort Z Nene
collection DOAJ
description The World Health Organization (WHO) published guidelines for hormonal contraceptive eligibility for women at high risk of HIV in March 2017. This guidance followed from a technical consultative meeting convened by the WHO in December 2016, where all the available evidence on hormonal contraceptives and risk of HIV acquisition was reviewed. This was an expert meeting with representation from global experts in family planning and HIV management, including clinicians, epidemiologists, researchers and civil society. The guideline development group, through a consensus, made recommendations to change the medical eligibility criteria for contraceptive use from category 1 to category 2 for progestogen-only injectable contraceptives among women at high risk of HIV. There was no change in the recommendation for all other methods of hormonal contraception. The data that informed this decision are from observational studies, which have limitations; therefore, causality or association of hormonal contraception and risk of HIV acquisition have not been proven. This guidance will have an impact on countries that have a high HIV disease burden and where progestogen-only injectable contraceptives are the highest used, as in South Africa (SA). The information has to be communicated in line with the WHO’s sexual and reproductive health rights principles of ensuring that all women should receive evidence-based recommendations. This will empower them to make informed choices about their reproductive needs. This article seeks to clarify the decision-making process of the WHO and how the new recommendations were formulated. It also gives SA’s response to the guidance and a perspective of what informed the National Department of Health’s position, taking into account the effect this will have on SA’s contraceptive guidelines.
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spelling doaj.art-b5527682c9284219a0fbefe4d01aebb42024-02-03T05:50:24ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352018-07-01108862963110.7196/SAMJ.2018.v108i8.13160Changes to the World Health Organization guideline on hormonal contraceptive eligibility for women at high risk of HIV: South African perspective and responseZ NeneG HofmeyrM PatelM PandayH ReesM MakuaY PillayThe World Health Organization (WHO) published guidelines for hormonal contraceptive eligibility for women at high risk of HIV in March 2017. This guidance followed from a technical consultative meeting convened by the WHO in December 2016, where all the available evidence on hormonal contraceptives and risk of HIV acquisition was reviewed. This was an expert meeting with representation from global experts in family planning and HIV management, including clinicians, epidemiologists, researchers and civil society. The guideline development group, through a consensus, made recommendations to change the medical eligibility criteria for contraceptive use from category 1 to category 2 for progestogen-only injectable contraceptives among women at high risk of HIV. There was no change in the recommendation for all other methods of hormonal contraception. The data that informed this decision are from observational studies, which have limitations; therefore, causality or association of hormonal contraception and risk of HIV acquisition have not been proven. This guidance will have an impact on countries that have a high HIV disease burden and where progestogen-only injectable contraceptives are the highest used, as in South Africa (SA). The information has to be communicated in line with the WHO’s sexual and reproductive health rights principles of ensuring that all women should receive evidence-based recommendations. This will empower them to make informed choices about their reproductive needs. This article seeks to clarify the decision-making process of the WHO and how the new recommendations were formulated. It also gives SA’s response to the guidance and a perspective of what informed the National Department of Health’s position, taking into account the effect this will have on SA’s contraceptive guidelines.http://www.samj.org.za/index.php/samj/article/download/12364/8556
spellingShingle Z Nene
G Hofmeyr
M Patel
M Panday
H Rees
M Makua
Y Pillay
Changes to the World Health Organization guideline on hormonal contraceptive eligibility for women at high risk of HIV: South African perspective and response
South African Medical Journal
title Changes to the World Health Organization guideline on hormonal contraceptive eligibility for women at high risk of HIV: South African perspective and response
title_full Changes to the World Health Organization guideline on hormonal contraceptive eligibility for women at high risk of HIV: South African perspective and response
title_fullStr Changes to the World Health Organization guideline on hormonal contraceptive eligibility for women at high risk of HIV: South African perspective and response
title_full_unstemmed Changes to the World Health Organization guideline on hormonal contraceptive eligibility for women at high risk of HIV: South African perspective and response
title_short Changes to the World Health Organization guideline on hormonal contraceptive eligibility for women at high risk of HIV: South African perspective and response
title_sort changes to the world health organization guideline on hormonal contraceptive eligibility for women at high risk of hiv south african perspective and response
url http://www.samj.org.za/index.php/samj/article/download/12364/8556
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