Hopkins Report: New Findings on Contraceptives
July 8, 2008
Baltimore, MD-Scores of health research findings appear every year. However, most of them do not get transferred into clinical practice because health care providers do not have the time to sort through all the information, or have limited access to it. The lag in research-to-practice for findings on contraceptive methods is addressed in the latest issue of Population Reports, "New Findings on Contraceptives," from the Johns Hopkins Bloomberg School of Public Health. The report also summarizes new research findings on contraceptive methods, interprets these findings in the context of previous research, and suggests implications for practice.
New research findings highlighted in the 20-page report published by the INFO Project at the Johns Hopkins Center for Communication Programs include:
Providers can now give clients the DMPA injection even if they are four weeks late without otherwise ruling out pregnancy. Based on new research and the existing body of evidence, the World Health Organization (WHO) Expert Working Group released this new guidance in April 2008 on re-injection schedules of the progestin-only injectable depot medroxyprogesterone acetate (DMPA).
Contrary to popular belief, a recent systematic review by the Cochrane Collaboration has shown that giving emergency contraceptive pills in advance does not result in increased sexual risk-taking. The mechanism of action of the progestin-only emergency contraceptive pills involves preventing ovulation.
Family Health International has developed a new checklist to help providers identify women who are at low risk for current sexually transmitted infections (STIs). These women could be medically eligible for IUD insertion. In resource-poor settings, this checklist and other similar tools and approaches are essential for improving access to IUDs. For women wanting to start a contraceptive method soon after childbirth, the IUD is a convenient, safe option that provides long-term contraception.
The Population Reports issue pays special attention to the contraceptive needs of women with HIV. "Hormonal contraceptive methods do not increase the risk of becoming infected with HIV. Also, new evidence confirms the low risk of pelvic infection among IUD users with HIV, supporting WHO guidance that many women with HIV-related conditions generally can start using an IUD," says author Deepa Ramchandran. Co-author Ruwaida Salem adds, "If a mother with HIV infection decides to breastfeed her infant, her health care provider should encourage and support her to breastfeed exclusively. Exclusive breastfeeding for the first six months of a baby's life poses less risk of mother-to-child transmission of HIV than giving the baby formula or solid foods in addition to breast milk. In addition, the mother avoids unintended pregnancy through the Lactational Amenorrhea Method (LAM) of family planning."
With the help of family planning experts in the field, the report also highlights some other important findings that have not yet translated into practice, namely:
Women who have not had children can use IUDs without fearing a greater risk of pelvic inflammatory disease (PID) and resulting infertility.
WHO suggests giving women up to one year's supply of hormonal contraceptive pills, if feasible. This encourages consistent contraceptive use.
Family planning providers can start clients on hormonal contraceptive methods at any time that they are reasonably certain that the woman is not pregnant. There is no need to wait for the next menstrual cycle to begin.
Healthy women do not need routine screening procedures to start most contraceptive methods.
For more information, contact: rsalem@jhuccp.org.
Find These Reports and Related Resources Online:
The full-text version of this 20-page Population Reports issue is available at: http://www.infoforhealth.org/pr/m20/NewFindings.pdf.
For a listing of all Population Reports issues online, go to http://www.populationreports.org. Population Reports is published three times a year in English, French, and Spanish by the INFO Project at the Johns Hopkins Bloomberg School of Public Health's Center for Communication Programs. The INFO Project receives support from the U.S. Agency for International Development.