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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Preference for Sayana® Press versus intramuscular Depo-Provera among HIV-positive women in Rakai, Uganda: A randomized crossover trial
Contraception, Volume 89, No. 5, Year 2014
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Description
Introduction Sayana Press (SP), a subcutaneous formulation of depot medroxyprogesterone acetate (DMPA) prefilled in a Uniject injection system, could potentially improve and expand contraceptive injection services, but acceptability of SP is unknown. HIV-positive women need contraception to avoid unintended pregnancy and risk of vertical HIV transmission. We assessed acceptability of SP versus intramuscular DMPA (DMPA-IM) among HIV-positive women and their care providers in Rakai, Uganda. Methods Women were randomized to DMPA-IM or SP at baseline, received the alternate product at 3 months, and chose their preferred method at 6 months. We determined preferences among new and experienced contraceptive injectable users who had tried both types of injection during the trial, and from providers before and after providing both types of injectables to clients. Results Among 357 women randomized, 314 were followed up at 6 months (88%). Although SP caused more skin irritation than DMPA-IM (3.8% vs. 0% at 6 months, p=.03), it was associated with marginally fewer side effects (30.4% vs. 40.4% at 6 months, p=.06). Participants reported high levels of willingness to recommend the DMPA contraception to a friend and satisfaction with the injection received, and these did not differ by injection type. Sixty-four percent of women and 73% of providers preferred SP to DMPA-IM at 6 months; women's preferences did not differ by previous experience with injectable contraception. Conclusions SP is acceptable to HIV-positive women and health care providers in this rural Ugandan population. Implications SP appears to be acceptable to HIV-positive women and their care providers in Rakai, Uganda, and strategies for appropriate rollout of this innovative technology should be explored. © 2014 Elsevier Inc.
Authors & Co-Authors
Polis, Chelsea B.
United States, Washington, D.c.
United States Agency for International Development
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Nakigozi, Gertrude F.
Uganda, Kalisizo
Rakai Health Sciences Program
Nakawooya, Hadijja
Uganda, Kalisizo
Rakai Health Sciences Program
Mondo, George E.
Uganda, Kalisizo
Rakai Health Sciences Program
Makumbi, Fredrick Edward
Uganda, Kampala
Makerere University College of Health Sciences
Gray, Ronald H.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Statistics
Citations: 30
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1016/j.contraception.2013.11.008
ISSN:
00107824
e-ISSN:
18790518
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Study Locations
Uganda
Participants Gender
Female