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Monitoring recommendations: Baseline investigations: Full blood count, B12 level, folate, and intrinsic factor antibodies (if pernicious anaemia suspected) During initial treatment: Potassium monitoring in severe deficiency (risk of hypokalaemia) Follow-up: Repeat full blood count after 8 weeks to confirm haematological response Long-term: Annual review to ensure compliance with maintenance injections

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But, she added: “Further evidence regarding the magnitude and mechanisms of the DMPA and HIV link among high-risk women, such as commercial sex workers and women in serodiscordant partnerships (where one partner is HIV-positive and the other is not), is urgently needed.” The possible rise in HIV infections among women using the contraceptive jab was first noted in 1991