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dc.contributor.authorHeff ron, Renee
dc.contributor.authorDonnell, Deborah
dc.contributor.authorRees, Helen
dc.contributor.authorCelum, Connie
dc.contributor.authorMugo, Nelly
dc.contributor.authorWere, Edwin
dc.contributor.authorde Bruyn, Guy
dc.contributor.authorNakku-Joloba, Edith
dc.contributor.authorNgure, Kenneth
dc.contributor.authorKiarie, James
dc.contributor.authorCoombs, Robert W.
dc.contributor.authorBaeten, Jared M.
dc.date.accessioned2002-03-23T21:16:05Z
dc.date.available2002-03-23T21:16:05Z
dc.date.issued2012-01-01
dc.identifier.citationUse 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.urihttp://dx.doi.org/10.1016/S1473-3099(11)70247-X
dc.identifier.urihttp://hdl.handle.net/10570/2027
dc.description.abstractBackground 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.sponsorshipUS National Institutes of Health and the Bill & Melinda Gates Foundationen_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.subjectContraceptivesen_US
dc.subjectHIVen_US
dc.subjectCohorten_US
dc.titleUse of hormonal contraceptives and risk of HIV-1 transmission: a prospective cohort studyen_US
dc.typeJournal article, peer revieweden_US


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