The ECHO Trial Results: Time to Act

June 27, 2019

In early June, Px Pulse posted an episode exploring the questions under investigation in the ECHO trial, a large study looking at three contraceptives to determine if any of them increased a woman’s risk of HIV.

Since then, leaders of the trial, formally called Evidence for Contraceptive options in HIV Outcomes, announced their findings: The study shows no substantial difference in HIV acquisition among women using three different, safe and effective contraceptive methods: DMPA-IM, the copper IUD or the LNG implant.

These data provide strong evidence to address the longstanding uncertainty around DMPA-IM and HIV, but they also sound an alarm-- HIV infection rates among the women in the study in East and Southern Africa were almost 4 percent, elevating the urgent need for improved HIV prevention efforts and integrated sexual and reproductive health services, all with women at the center.

In this episode, two veteran women’s advocates from Kenya and South Africa, Jaqueline Wambui and Yvette Raphael, talk about what these data mean for advocacy now. Helen Rees and Nelly Mugo, members of the leadership team of the ECHO study, explain the trial results and their implications. And the World Health Organization’s James Kiarie shares the importance of the WHO guidelines and more.

Listen to the full podcast (16:21)

Highlights

• Dr. Nelly Mugo’s and Dr. Helen Rees’ key take-aways from the trial results (9:47)
• A call to action from women’s advocates Jaqueline Wambui and Yvette Raphael (2:34)
• WHO’s Dr. James Kiarie on next steps and his call for prioritizing choice (3:57)
• Our early June episode, The ECHO Trial: Preparing for Action, provides background on the trial design and conduct.

Additional Resources

Study Results and Background

• ECHO results presentation at SA AIDS 2019 [video] – The ECHO Consortium
• ECHO results slides [PowerPoint] – The ECHO Consortium
• ECHO study primary HIV Results Publication – The Lancet
• How should we listen to ECHO? – The Lancet commentary
• A Roadmap for Results: Understanding the ECHO Study Results [webinar] – FP2020, AVAC
• ECHO study press release – The ECHO Consortium website
• ECHO study page – AVAC
• Understanding the Results of the ECHO Study – AVAC

Public Statements

• An Urgent Need to Prioritize Woman-Centered and Integrated Contraception and HIV Prevention and Treatment Options — APHA, AVAC, Family Planning 2020, ICWEA, PAI, Planned Parenthood Federation of America
• Pivotal ECHO Study Provides Reassuring Evidence on HIV Risk and Contraceptives – AVAC
• Statement on ECHO Trial Results – Global Civil Society Working Group on HC-HIV
• New Study Finds No Link Between HIV Infection and Contraceptive Methods – WHO
• Using the Only Birth Control in Stock Isn't a Choice, It's a Sign Something's Wrong – Yvette Raphael