In a Nature News opinion piece, James Shelton, science adviser for USAID’s Bureau for Global Health, discusses media coverage of recent findings from the journal Lancet Infectious Diseases showing that women’s use of hormonal contraception (HC) may increase the risk of HIV acquisition or transmission. “Whether HC influences HIV risk is a serious concern, and has been the subject of numerous studies. But these studies have been observational and not randomized, and thus potentially biased by who chooses to use HC,” Shelton writes. He uses “causality criteria laid down by British epidemiologist Austin Bradford Hill” to analyze the results, adding, “I find the evidence far from persuasive.”

He reviews coverage of the data presented by the study authors, comment authors, the journal and the New York Times, saying that these actors presented “little critical thinking” in their reviews. Shelton concludes that the possible relationship between HC and HIV acquisition and transmission “remains a complicated and serious issue,” and “[w]e deserve better [reporting], from all involved” (11/2).