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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
The effect of hormonal contraception on genital tract shedding of HIV-1
AIDS, Volume 18, No. 2, Year 2004
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Description
Objective: A previous cross-sectional study reported that hormonal contraception may be associated with increased infectivity in HIV-1 infected women. We conducted a prospective study to determine if cervical shedding of HIV-1 increased after initiating hormonal contraception. Design: Shedding of HIV-1 DNA (a marker of HIV-1 infected cells) and HIV-1 RNA were measured before and after initiating hormonal contraception. Methods: HIV-1 seropositive women were recruited from a Kenyan family planning clinic. At baseline, cervical secretions were collected for HIV-1 DNA and RNA assays in women initiating hormonal contraception; follow-up samples were collected a median of 64 days later. Results: One-hundred and one women chose depot medroxyprogesterone (Depo), 53 chose low-dose oral contraceptives (OC), seven high-dose OC, and 52 progesterone-only OC. At follow-up, there was a significant increase in the prevalence of cervical HIV-1 DNA detection [from 42% to 52%, odds ratio (OR), 1.62; 95% confidence interval (CI), 1.03-2.63) for all hormonal contraception combined, and a trend for an increase for each individual type. Although the prevalence of cervical HIV-1 RNA increased slightly (from 82% to 86%; OR, 1.56; 95% CI, 0.83-3.03), the concentration of cervical HIV-1 RNA did not change significantly overall (from 2.81 to 2.84 log10 copies/swab; P = 0.77) or for individual contraception types. Conclusions: A modest but significant increase in shedding of HIV-1 DNA but not of HIV-1 RNA was detected after starting hormonal contraception. Our results may have important implications regarding the infectivity of women using hormonal contraception, and highlight the need for epidemiologic studies of transmission rates from women using and not using hormonal contraception. © 2004 Lippincott Williams & Wilkins.
Authors & Co-Authors
Wang, Chia C.
United States, Seattle
University of Washington
McClelland, Raymond Scott
United States, Seattle
University of Washington
Overbaugh, Julie M.
United States, Seattle
Fred Hutchinson Cancer Research Center
Reilly, Marie
Sweden, Stockholm
Karolinska Institutet
Panteleeff, Dana De Vange
United States, Seattle
Fred Hutchinson Cancer Research Center
Mandaliya, Kishor N.
Kenya, Mombasa
Coast Provincial General Hospital, Kenya
Chohan, Bhavna H.
Kenya, Nairobi
University of Nairobi
Lavreys, Ludo
United States, Seattle
University of Washington
Ndinya-Achola, Jeckoniah O.
Kenya, Nairobi
University of Nairobi
Kreiss, Joan K.
United States, Seattle
University of Washington
Statistics
Citations: 104
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1097/00002030-200401230-00009
Research Areas
Genetics And Genomics
Health System And Policy
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study
Study Approach
Quantitative
Participants Gender
Female