Wednesday, August 5, 2015

Institutionalizing Violence Against Women (and Men)

It is not news that injectible Depo Provera (DMPA, a hormonal contraceptive) doubles the risk of HIV negative women being infected, and doubles the risk of HIV positive women infecting their sexual partner with HIV. Nor is it news that injectible Depo is mostly used in developing countries, and among non-white people in the US. Therefore, it tends to be used in places where HIV prevalence is higher, and among populations with higher prevalence in low prevalence countries.
Why use injectible Depo when this is well known? Defenders of the product claim that using it cuts other risks, such as unplanned pregnancies, particularly among HIV positive women. They feel this mitigates the risk of transmitting the virus, or of becoming infected. Strange logic, but such is the mindset of the HIV industry, and those who (very strenuously and aggressively) defend the use of injectible Depo.
If various NGOs, public health programs, research programs and others wanted to carry out their work ethically, they would tell the women (and hopefully their sexual partners) about the doubling in risk of HIV transmission, but the warnings given are vague. Therefore, women (and men) are put at increased risk of being infected with HIV, or of infecting others. Many of these same NGOs, their funders and associates would also claim to be opposed to violence against women. But failing to inform them about the increased risk constitutes violence against women (and men).
Stupider still is the proposal to use PrEP (pre-exposure prophylaxis, antiretroviral drugs taken to prevent infection) to reduce the risk that injectible Depo will increase HIV transmission. Why not just use a different hormonal contraceptive, preferably an oral form? Well, one of the arguments for not using an oral form is that some sexual partners may object to women using oral contraceptives, especially if they are married to the woman. It is argued that women can be given Depo Provera once every three months, without their sexual partner knowing.
But will the partner not wonder why the woman is taking oral PrEP? And if they try to find out why she is taking it, may they not also find out that the woman is HIV positive, believes her sexual partner to be HIV positive, or is taking injectible contraceptives? Are we not back to square one?
Where are the narcissistic 'feminist' stars of film, music and other arts when you need them? They are too busy screaming about what sex workers want (or should want) to see real violence against women, happening right in front of them. Many of those being (aggressively) persuaded to use injectible Depo Provera are sex workers (or are believed to be by those doing the persuading). What about their right to know the risks from injectible hormonal contraceptive to themselves and their partners?
It is claimed that using injectible Depo Provera can protect women from violence; but it also constitutes an act of violence against them and their sexual partners. In addition, the 'protective' value of Depo Provera (against violence, not HIV) is lost if the woman also takes PrEP (to protect her against HIV). The use of injectible Depo Provera is an act of institutionalized violence against women (and men). It should not be used as a vehicle for selling pre-exposure prophylaxis.



KOTFrank said...

I don't see how injectable Depo Provera (DMPA, a hormonal contraceptive) doubles the risk of HIV? Is it the injection or the hormonal drug? or something else?

Simon said...

Thank you Frank, here are a couple of links on the subject:

I think both may be involved but researchers are reluctant to say what mechanism (or mechanisms) is at work here. While I believe Depo Provera (DMPA) injections are often administered using pre-filled syringes, there is nothing to stop people from halving the dose, to save money for example, or because they are running short of supplies. Unsafe injection practices are rife in high HIV prevalence countries (and high hepatitis C countries).

The systemic effect of the hormonal drug has also been suspected of increasing the likelihood of transmitting HIV and being infected with it. Again, this is not a new discovery. As you can imagine, Pfizer is very anxious to protect their profits, which probably explains why this drug is mostly promoted among very poor and vulnerable people, with little education, access to safe healthcare facilities, with few other options available to them.

At times, the way Depo Provera is aggressively marketed is reminiscent of the way mass male circumcision programs are marketed, with the same apparent contempt for human rights, research ethics and common decency. As you know, there is no known mechanism by which mass male circumcision could reduce HIV transmission from women to men (nor even a well recognized mechanism by which HIV is transmitted from women to men via penile-vaginal sex); but that hasn't stopped the programs.