Self-administration of subcutaneous depot medroxyprogesterone acetate for contraception: feasibility and acceptability

Is a lower-dose, subcutaneous contraceptive injectable containing depot medroxyprogesterone acetate likely to impact women's risk of HIV?

“…Women [13, 14] and health workers [15] have expressed preferences for DMPA-SC over DMPA-IM. Studies have documented interest in self-injection [16, 17] and feasibility has been assessed in Senegal, Uganda, Malawi, and elsewhere [12, 18–23]. Sayana® Press has been approved for self-injection in several countries [12].…”

Subcutaneous depo-medroxyprogesterone acetate

“…In both studies continuation rates with the method were high at the end of 1 year (74% and 88% in the USA and UK, respectively). In both studies most women (87% and 90%) reported that self-administration was easy and that they would recommend the method to a friend (94% and 95%) 6 9. The third study showed that self-administration of DMPA-SC was feasible even in teenagers after brief training 10.…”

“…To date, there have been three studies of self-administration of DMPA-SC 6 9 10. In two studies, conducted in the USA (50 women) and the UK (64 women), women were taught to self-inject, and when deemed competent gave themselves their first injection under the supervision of the study co-ordinator, and were then given a further three supplies (equivalent to 1 year of contraception) to take home to self-administer 6 9.…”

“…In two studies, conducted in the USA (50 women) and the UK (64 women), women were taught to self-inject, and when deemed competent gave themselves their first injection under the supervision of the study co-ordinator, and were then given a further three supplies (equivalent to 1 year of contraception) to take home to self-administer 6 9. In both studies continuation rates with the method were high at the end of 1 year (74% and 88% in the USA and UK, respectively).…”

“…In all studies conducted to date the DMPA-SC that was used was packaged as a prefilled syringe with a separate SC needle that needed to be attached to the syringe. Training women to self-administer using this DMPA-SC delivery system (which is arguably more complicated than the Uniject system) was estimated to take less than 30 minutes 6 9…”