dc.contributor.author | Heff ron, Renee | |
dc.contributor.author | Donnell, Deborah | |
dc.contributor.author | Rees, Helen | |
dc.contributor.author | Celum, Connie | |
dc.contributor.author | Mugo, Nelly | |
dc.contributor.author | Were, Edwin | |
dc.contributor.author | de Bruyn, Guy | |
dc.contributor.author | Nakku-Joloba, Edith | |
dc.contributor.author | Ngure, Kenneth | |
dc.contributor.author | Kiarie, James | |
dc.contributor.author | Coombs, Robert W. | |
dc.contributor.author | Baeten, Jared M. | |
dc.date.accessioned | 2002-03-23T21:16:05Z | |
dc.date.available | 2002-03-23T21:16:05Z | |
dc.date.issued | 2012-01-01 | |
dc.identifier.citation | Use of hormonal contraceptives and risk of HIV-1 transmission: a prospective cohort study Renee Heffron MPH,Deborah Donnell PhD,Prof Helen Rees MBBChir,Prof Connie Celum MD,Nelly Mugo MBChB,Edwin Were MBChB,Guy de Bruyn MBBCh,Edith Nakku-Joloba MBChB,Kenneth Ngure MPH,James Kiarie MBChB,Prof Robert W Coombs MD,Jared M Baeten MD,for the Partners in Prevention HSV/HIV Transmission Study Team The Lancet Infectious Diseases - 1 January 2012 ( Vol. 12, Issue 1, Pages 19-26 ) | en_US |
dc.identifier.uri | http://dx.doi.org/10.1016/S1473-3099(11)70247-X | |
dc.identifier.uri | http://hdl.handle.net/10570/2027 | |
dc.description.abstract | Background Hormonal contraceptives are used widely but their eff ects on HIV-1 risk are unclear. We aimed to assess
the association between hormonal contraceptive use and risk of HIV-1 acquisition by women and HIV-1 transmission
from HIV-1-infected women to their male partners.
Methods In this prospective study, we followed up 3790 heterosexual HIV-1-serodiscordant couples parti cipating in
two longitudinal studies of HIV-1 incidence in seven African countries. Among injectable and oral hormonal
contraceptive users and non-users, we compared rates of HIV-1 acquisition by women and HIV-1 transmission from
women to men. The primary outcome measure was HIV-1 seroconversion. We used Cox proportional hazards
regression and marginal structural modelling to assess the eff ect of contraceptive use on HIV-1 risk.
Findings Among 1314 couples in which the HIV-1-seronegative partner was female (median follow-up
18·0 [IQR 12·6–24·2] months), rates of HIV-1 acquisition were 6·61 per 100 person-years in women who used
hormonal contraception and 3·78 per 100 person-years in those who did not (adjusted hazard ratio 1·98, 95% CI
1·06–3·68, p=0·03). Among 2476 couples in which the HIV-1-seronegative partner was male (median follow-up
18·7 [IQR 12·8–24·2] months), rates of HIV-1 transmission from women to men were 2·61 per 100 person-years in
couples in which women used hormonal contraception and 1·51 per 100 person-years in couples in which women
did not use hormonal contraception (adjusted hazard ratio 1·97, 95% CI 1·12–3·45, p=0·02). Marginal structural
model analyses generated much the same results to the Cox proportional hazards regression.
Interpretation Women should be counselled about potentially increased risk of HIV-1 acquisition and transmission
with hormonal contraception, especially injectable methods, and about the importance of dual protection with
condoms to decrease HIV-1 risk. Non-hormonal or low-dose hormonal contraceptive methods should be considered
for women with or at-risk for HIV-1. | en_US |
dc.description.sponsorship | US National Institutes of Health and the Bill & Melinda Gates Foundation | en_US |
dc.language.iso | en | en_US |
dc.publisher | Elsevier | en_US |
dc.subject | Contraceptives | en_US |
dc.subject | HIV | en_US |
dc.subject | Cohort | en_US |
dc.title | Use of hormonal contraceptives and risk of HIV-1 transmission: a prospective cohort study | en_US |
dc.type | Journal article, peer reviewed | en_US |