Monday, January 5, 2015
If there was an injectible birth control method that doubled the risk of HIV positive people using it infecting their partner, and also doubled the risk that HIV negative people using it would be infected themselves (if their partner is infected), you'd expect the WHO to issue a warning, right?
But Depo-Provera (DMPA) is widely marketed by NGOs and other institutions running family planning programs in developing countries, and WHO (World Health Organization) evidently believes that reducing births is more important than safety.
This is great for Pfizer, and now, thanks to their new symbiotic relationship, it's great for Gilead too, because women using Depo-Provera may be able to reduce their risk of being infected, or of infecting their partner. All they have to do is take drugs kindly produced by Gilead, in the form of pre-exposure prophylaxis (the use of antiretroviral drugs, either daily or intermittently, to reduce the risk of infection with HIV).
You might think that this would not happen, that surely, Depo-Provera would be taken off the market, or at least carry a warning. But companies such as Pfizer and Gilead have been very successful in getting institutions like the WHO, along with various universities and donors (such as those listed in the AIDS Journal article), to help them market their products.
PrEP is something of a solution in search of a problem. It is possible that HIV negative people who wish to have unprotected sex with HIV positive people (or people whose status is unknown) would be able to reduce their risk of being infected. But the majority of people in African countries are probably not in this position; PrEP is likely to be more of a recreational drug for wealthy countries.
If people wish to reduce their risk of being infected with HIV (or of infecting others) they would be well advised to avoid Depo-Provera. There are plenty of other birth control methods, some of which also protect against HIV and various sexually transmitted infections.
The problem is that HIV positive people using Depo-Provera and HIV negative people whose partners use it are not being warned about these well documented risks. They are not suffering from a lack of pre-exposure prophylaxis, but they might be suffering from poor, incomplete or biased family planning advice.
There are industry sponsored trolls on social media sites, Twitter for example, who pounce on anyone who tries to question the safety of Depo-Provera. But the above AIDS Journal article seems to confirm what critics have been saying, while at the same time offering another patented solution that can be taken in conjunction with the discredited birth control method.
In contrast to PrEP, Depo-Provera seems to be almost exclusively marketed to poor people in rich countries and to anyone and everyone in poor countries. No conflict of interest is declared in the peer-reviewed journal that published the paper, and the donors listed are all well known and highly influential, particularly in relation to Depo-Provera studies.
Posted by Simon at 12:27 PM