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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Hormonal contraception and the risk of HIV acquisition
AIDS, Volume 21, No. 1, Year 2007
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Description
BACKGROUND: Combined oral contraceptives (COC) and depot- medroxyprogesterone acetate (DMPA) are among the most widely used family planning methods; their effect on HIV acquisition is not known. OBJECTIVE: To evaluate the effect of COC and DMPA on HIV acquisition and any modifying effects of other sexually transmitted infections. METHODS: This multicenter prospective cohort study enroled 6109 HIV-uninfected women, aged 18-35 years, from family planning clinics in Uganda, Zimbabwe and Thailand. Participants received HIV testing quarterly for 15-24 months. The risk of HIV acquisition with different contraceptive methods was assessed (excluding Thailand, where there were few HIV cases). RESULTS: HIV infection occurred in 213 African participants (2.8/100 woman-years). Use of neither COC [hazard ratio (HR), 0.99; 95% confidence interval (CI), 0.69-1.42] nor DMPA (HR, 1.25; 95% CI, 0.89-1.78) was associated with risk of HIV acquisition overall, including among participants with cervical or vaginal infections. While absolute risk of HIV acquisition was higher among participants who were seropositive for herpes simplex virus 2 (HSV-2) than in those seronegative at enrolment, among the HSV-2-seronegative participants, both COC (HR, 2.85; 95% CI, 1.39-5.82) and DMPA (HR, 3.97; 95% CI, 1.98-8.00) users had an increased risk of HIV acquisition compared with the non-hormonal group. CONCLUSIONS: No association was found between hormonal contraceptive use and HIV acquisition overall. This is reassuring for women needing effective contraception in settings of high HIV prevalence. However, hormonal contraceptive users who were HSV-2 seronegative had an increased risk of HIV acquisition. Additional research is needed to confirm and explain this finding. © 2007 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Morrison, Charles S.
United States, Research Triangle Park
Clinical Research Department
United States, Durham
Fhi 360
Richardson, Barbra Ann
United States, Seattle
University of Washington
Mmiro, Francis A.
Uganda, Kampala
Makerere University
Chipato, Tsungai
Zimbabwe, Harare
University of Zimbabwe
Celentano, David D.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Luoto, Joanne
United States, Bethesda
National Institute of Child Health and Human Development Nichd
Mugerwa, Roy D.
Uganda, Kampala
Makerere University
Padian, Nancy S.
United States, San Francisco
University of California, San Francisco
Rugpao, Sungwal
Thailand, Chaing Mai
Chiang Mai University
Brown, Joelle Morgan
United States, San Francisco
University of California, San Francisco
Cornelisse, Peter
United States, Seattle
Children's Hospital and Regional Medical Center
Salata, Robert A.
United States, Cleveland
Case Western Reserve University
Statistics
Citations: 226
Authors: 12
Affiliations: 11
Identifiers
Doi:
10.1097/QAD.0b013e3280117c8b
Research Areas
Environmental
Health System And Policy
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
Uganda
Zimbabwe
Participants Gender
Female