Dear Editor,
Injectable contraceptives are twice as popular in sub-Saharan Africa as they are in the United States not only because they are long-lasting and convenient, but because they are almost always unable to be detected by male partners. For women whose reproduction would otherwise be controlled by their partner, injectables offer a safe and discrete method of pregnancy prevention.
Well, almost safe. As "Contraceptive Used in Africa May Double Risk of H.I.V." (news, Oct. 4) illustrates, more research is needed to evaluate the risks associated with injectables. Simultaneously, though, as Dr. Lavreys emphasizes in the article, it is imperative that W.H.O. recommend and make available other methods of contraception before changing its position on injectables.
For W.H.O. to simply promote abstinence or condom-use would not address the lack of reproductive control that women in sub-Saharan Africa face. The agency has an opportunity to address this obstacle and recommend other virtually undetectable methods of birth control, such as implants and intrauterine devices.
Sincerely,
Kate Troja
Berkeley, C.A.
Kate,
ReplyDeleteI like your observation that injectable contraceptives are one of the most culturally-appropriate contraceptive options for women in sub-Saharan Africa. What many people do not understand is that not every method is applicable everywhere in the world. Cultural, social and environmental factors must be taken into consideration. This applies to health issues as much as it does to economical and political issues, as can be seen by this example. As an international organization, the WHO should understand this concept and always keep it in mind. I agree that the health risks of injectable contraceptives should be considered and examined further, but they should not be completely abandoned. Women in sub-Saharan Africa should have this option, or at least a comparable option, that meets their needs appropriately and safely (both physically and socially).
Kate,
ReplyDeleteThis is an interesting dilemma that has been brought up. I agree with your point that there needs to be other options, not just abstinence or condoms, which can be ineffective in male-dominated societies. And as Karla mentions, new implementations need to consider all major factors, most importantly, societal and cultural influences. There have been many interventions in Sub-Saharan Africa done where the focus was on empowering women by forming community groups that discuss family planning and practicing safe sex and has had very positive results. Personally, it sounds absurd that a injectable is still in use that increases likelihood of transmission of HIV, especially in an area where the prevalence is so high.
Thank you for sharing this article,
Nick
Hi Kate,
ReplyDeleteI also found this article very interesting, because it discusses an increased use in contraceptives, which is great, but it also has led to an increase in contracting HIV in Africa because those contraceptives do not protect against sexually transmitted diseases. Normally we would encourage the use of condoms or abstinence, but it is crucial to be sensitive to differences in cultural and social circumstances in other countries, and to acknowledge that not all public health measures and policies work in different countries.
In Sub-Saharan Africa, in a patriarchal and male-dominated society, condoms and abstinence do not offer the same benefit of giving women discrete control over their reproduction the same way as injectable contraceptives do. I also feel that it is important for the WHO to consider all factors when thinking of possible solutions to important health issues like this especially because there are other social issues going on in the community. However, I do still think that injectables should be made available until a better alternative is found because it still provides some sort of pregnancy prevention.
Sincerely,
Michelle Leu