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

来源：

JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES | 2014年 / 66卷 / 04期

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

页码：452 / 456

页数：5

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