A Prospective Cohort Study of the Effect of Depot Medroxyprogesterone Acetate on Detection of Plasma and Cervical HIV-1 in Women Initiating and Continuing Antiretroviral Therapy

被引:14
|
作者
Day, Summer [1 ]
Graham, Susan M. [1 ,2 ]
Masese, Linnet N. [3 ]
Richardson, Barbra A. [4 ,5 ,6 ]
Kiarie, James N. [7 ]
Jaoko, Walter [2 ]
Mandaliya, Kishorchandra [8 ]
Chohan, Vrasha [1 ,6 ]
Overbaugh, Julie [6 ]
McClelland, R. Scott [1 ,2 ,3 ,5 ]
机构
[1] Univ Washington, Dept Med, Seattle, WA 98104 USA
[2] Univ Nairobi, Dept Med Microbiol, Nairobi, Kenya
[3] Univ Washington, Dept Epidemiol, Seattle, WA 98104 USA
[4] Univ Washington, Dept Biostat, Seattle, WA 98104 USA
[5] Univ Washington, Dept Global Hlth, Seattle, WA 98104 USA
[6] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA
[7] Univ Nairobi, Dept Obstet & Gynaecol, Nairobi, Kenya
[8] Pathcare Labs, Mombasa, Kenya
基金
美国国家卫生研究院;
关键词
hormonal contraception; HIV-1; antiretroviral therapy; DMPA; HORMONAL CONTRACEPTION; COMPETING RISKS; TRANSMISSION; ACQUISITION; ADHERENCE; RNA;
D O I
10.1097/QAI.0000000000000187
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Depot medroxyprogesterone acetate (DMPA) use among HIV-1-infected women may increase transmission by increasing plasma and genital HIV-1 RNA shedding. We investigated associations between DMPA use and HIV-1 RNA in plasma and cervical secretions. One hundred two women initiated antiretroviral therapy, contributing 925 follow-up visits over a median of 34 months. Compared with visits with no hormonal contraception exposure, DMPA exposure did not increase detection of plasma (adjusted odds ratio: 0.81, 95% confidence interval: 0.47 to 1.39) or cervical HIV-1 RNA (adjusted odds ratio: 1.41, 95% confidence interval: 0.54 to 3.67). Our results suggest that DMPA is unlikely to increase infectivity in HIV-positive women who are adherent to effective antiretroviral therapy.
引用
收藏
页码:452 / 456
页数:5
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