Ahmed K, Baeten JM, Beksinskag M, et al. - Via a randomized, multicenter, open-label trial across 12 research sites in eSwatini, Kenya, South Africa, and Zambia of 7,830 HIV-seronegative African women aged 16–35 years looking for efficient contraception, without medical contraindications contraceptive methods used in the trial, who agreed to use the assigned method for 18 months, and reported not using injectable, intrauterine, or implantable contraception for the previous 6 months, researchers assessed depot medroxyprogesterone acetate (DMPA-IM), a copper intrauterine device (IUD), vs a levonorgestrel (LNG) implant. A total of 2,609 were randomized to the DMPA-IM group, 2,607 to the copper IUD group, and 2,613 to the LNG implant group. There were 397, 138, and 116 HIV infections, respectively, seen in the DMPA-IM group, the copper IUD group, and the LNG implant group. Adverse events leading to discontinuation of the randomly allocated method occurred in 109, 218, and 226 women in the DMPA-IM group, copper IUD group, LNG implant group, respectively. In the DMPA-IM group, the copper IUD group and LNG implant group, respectively, 61, 116, and 78 pregnancies occurred, out of total 255 pregnancies. Following discontinuation of the randomly allocated method, 181 pregnancies occurred. Therefore, no substantial variation in HIV risk among the methods assessed was found and every method was safe and highly efficacious. In this population of women seeking pregnancy prevention, HIV incidence was high, indicating the necessity for integration of HIV prevention within contraceptive services for African women.