Title: HIV and fertility regulation.

POPLINE Document Number: 048986

Author(s):

Harlap S

Source citation:

[Unpublished] 1987 Jul 22. 19, [6] p. (0446f)

Abstract:

Greater clarity is needed on the questions of how human immunodeficiency virus (HIV) affects the risks and benefits of various contraceptive methods, as well as how contraceptives affect the risk and clinical course of HIV. These questions are relevant because some contraceptives can change the microanatomy and physiology of the reproductive tract, their use is often associated with changes in the incidence of certain infections and neoplasms, and steroid hormones may alter the uptake or release of certain retroviruses by cells or change retroviral replication. HIV may be stimulated by sex steroids, in which case pregnancy and use of hormonal contraception may increase HIV acquisition or accelerate the development of immunosuppression. In addition, HIV may induce enzymes that influence the metabolic pathways for contraceptive steroid breakdown, thus jeopardizing contraceptive efficacy. On the other hand, there is at this point no indication that the risks posed by hormones in terms of HIV are any greater than those from IUDs, sterilization, or abortion. There is an urgent need to develop decision trees and risk/benefit equations for the use of different contraceptives in populations with high, medium, and low risk of HIV infection when the antibody status of individuals is not necessarily known. Much of the information needed to develop these models is currently lacking and must be provided by research. The acquired immunodeficiency syndrome (AIDS) epidemic has changed several priorities in the field of contraceptive development. 1st, barrier methods need to be re-evaluated and their technology and acceptability improved. 2nd, the continuous delivery of systemic or local viricidal agents through silastic implants, vaginal rings, and IUDs should be explored. And 3rd, clinical trials of new contraceptives should include assessments of their effects on the immune system.

Keywords:

AIDS
HIV Infections
Viral Diseases
Diseases
Research and Development
Research Methodology
Contraception
Family Planning
Hormones
Reproductive Control Agents
Steroid Metabolic Effects
Metabolic Effects
Immunological Effects
Technology
Economic Factors
Endocrine System
Physiology
Biology
Immunity
Immune System