Oral and Injectable Contraceptive Use and HIV Acquisition Risk Among Women in 4 African Countries: A Secondary Analysis of Data from a Microbicide Trial

December 2015 - Structural Prevention

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Balkus, J.E., Brown, E.R., Hillier, S.L., et al. Contraception (October 2015), pii: S0010-7824(15)30033-0. doi: 10.1016/j.contraception.2015.10.010, E-publication ahead of print.

The authors estimated the association between self-reported use of injectable hormonal contraceptives or HCs (depot medroxyprogesterone acetate, or DMPA, or norethisterone oenanthate, or NET-EN) or oral contraceptive pills and HIV acquisition risk among 2,830 African women enrolled in the analysis. The HIV Prevention Trials Network (HPTN) 035 microbicide trial, a multi-site, randomized, controlled trial, compared BufferGel and 0.5 percent PRO 2000 gel against two comparator arms (hydroxycellulose placebo and no gel). During the study, participants were given HIV testing and were interviewed about self-reported contraceptive use and sexual behaviors. The authors reported that they did not observe a significant increased risk of HIV acquisition among women using injectable or oral contraceptive methods. They did not observe statistically significant interactions between baseline age or herpes simplex virus status and HC method. They concluded that these findings supported the World Health Organization's recommendation that women at high risk for HIV, including those using progestogen-only injectable HC, should be strongly advised to always use condoms in addition to other HIV prevention measures. 

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