Commentary: Hormonal contraception and HIV acquisition—current evidence and ongoing research needs

Hormonal methods of contraception—primarily combined oral contraceptives (COC) and injectable progestin-only contraception—are among the most widely used forms of reversible contraception worldwide. Over 100 million women use these methods1 and use is particularly high in many areas, such as sub-Saharan Africa, where HIV and other sexually transmitted infections (STIs) are highly prevalent. Use of injectable, progestin-only contraceptives including the 3-monthly injectable depot-medroxyprogesterone acetate (DMPA) and the 2-monthly injectable norethindrone enanthate (NET-EN) appear to be increasing rapidly in such areas. Thus, understanding whether women’s use of hormonal contra-ception increases their risk of HIV acquisition is critically important. Conclusive evidence of a relationship between hormona