The NWHN’s Statement on the Results of the Evidence for Contraceptive Options and HIV trial (ECHO)

The following statement can be attributed to Cynthia A. Pearson, Executive Director of the National Women’s Health Network.

The National Women’s Health Network (The NWHN) is pleased that the results of the ECHO trial provide reassuring evidence that Depo Provera does NOT significantly increase the risk of HIV infection when compared to the copper IUD and a levonorgestrel implant (brand name: Jadelle). The trial, which was conducted in four countries in east and southern Africa, enrolled more than 7,800 women who wanted to use a contraceptive method. We applaud these women for their contribution to our knowledge about the safety of commonly used contraceptives. They agreed to allow the selection of their contraceptive method to be made at random, and to use that method for 18 months. This large randomized trial was designed to more fully explore the findings from earlier research of a possible increased risk of HIV infection in women using Depo Provera, a synthetic form of progesterone. The ECHO trial cannot rule out a small increased risk, but the trial’s large size and careful follow-up of all participants provide convincing evidence that there is not a significant increased risk.  

The ECHO trial was launched in 2015, after a years-long effort by the NWHN, SisterLove, HIV Prevention Justice Alliance and many other HIV and women’s advocacy organizations to demand that funders of international family planning programs invest in research to explore the safety of Depo Provera. Collectively, we insisted that women’s reproductive needs not be addressed in isolation from the rest of their lives, including their risk of HIV and other sexually transmitted infections. People who use contraceptives deserve to have information of the highest possible quality to answer their questions about side effects, complications, increased risk of other infections and long-term effects. The NWHN began this work in the 1970s when it successfully called on the United States Food and Drug Administration (FDA) to use its regulatory power to require that the manufacturer of Depo Provera conduct the full spectrum of research on its health effects to justify its formal approval as a contraceptive method. We applaud the work of multiple organizations and individuals in the United States and Africa who influenced the design, conduct and oversight of the ECHO trial.

The National Women’s Health Network is supported by our members and by choice we do not accept financial support from drug companies or medical device manufacturers. We bring the voices, concerns and needs of women consumers to policy and regulatory tables.

Cindy Pearson was the NWHN’s Executive Director from 1996 to 2021. One of the nation's leading advocates for women's health, Cindy often testified before Congress,  NIH and the FDA and was frequently featured in the news as a consumer expert on women’s health issues. When she retired, Cindy received a Congressional Resolution in honor of her outstanding contributions to the health of women and girls.

Read more from Cindy Pearson.