Journal article
Associations of hormonal contraceptive use with measures of HIV disease progression and antiretroviral therapy effectiveness
Contraception (Stoneham), Vol.93(1), pp.17-24
01/01/2016
DOI: 10.1016/j.contraception.2015.07.003
PMCID: PMC4688178
PMID: 26197261
Abstract
To examine the associations between hormonal contraceptive use and measures of HIV disease progression and antiretroviral treatment (ART) effectiveness.
A prospective cohort study of women with prevalent HIV infection in St. Petersburg, Russia, was conducted. After contraceptive counseling, participants chose to use combined oral contraceptives (COCs), depot-medroxyprogesterone acetate (DMPA), a copper intrauterine device (IUD) or male condoms for pregnancy prevention. Among participants not using ART at enrollment, we used multivariate Cox regression to assess the association between current (time-varying) contraceptive use and disease progression, measured by the primary composite outcome of CD4 decline to <350cells/mm3, ART initiation or death. Among participants using ART at enrollment, we used linear mixed models to estimate the predicted mean CD4 change at select time points by contraceptive method.
During a total of 5233months follow-up among participants not using ART with enrollment CD4 ≥350cells/mm3 (n=315), 97 experienced disease progression. Neither current use of COCs [adjusted hazard ratio (aHR) 0.91, 95% confidence interval (CI) 0.56–1.48] nor DMPA (aHR 1.28, 95% CI 0.71–2.31) was associated with a statistically significant increased risk for disease progression compared with use of nonhormonal methods (IUD or condoms). Among participants using ART at enrollment (n=77), we found no statistically significant differences in the predicted mean changes in CD4 cell count comparing current use of COCs (p=.1) or DMPA (p=.3) with nonhormonal methods.
Hormonal contraceptive use was not significantly associated with measures of HIV disease progression or ART effectiveness among women with prevalent HIV infection.
Hormonal contraceptive use was not significantly associated with measures of HIV disease progression or ART effectiveness among women with prevalent HIV infection.
Details
- Title: Subtitle
- Associations of hormonal contraceptive use with measures of HIV disease progression and antiretroviral therapy effectiveness
- Creators
- Maura K. Whiteman - National Center for Chronic Disease Prevention and Health PromotionGary Jeng - National Center for Chronic Disease Prevention and Health PromotionAnna Samarina - St. Petersburg AIDS Center, St. Petersburg, RussiaNatalia Akatova - St. Petersburg AIDS Center, St. Petersburg, RussiaMargarita Martirosyan - St. Petersburg AIDS Center, St. Petersburg, RussiaDmitry M. Kissin - Centers for Disease Control and PreventionKathryn M. Curtis - Centers for Disease Control and PreventionPolly A. Marchbanks - Centers for Disease Control and PreventionSusan D. Hillis - National Center for Chronic Disease Prevention and Health PromotionMichele G. Mandel - Centers for Disease Control and PreventionDenise J. Jamieson - National Center for Chronic Disease Prevention and Health Promotion
- Resource Type
- Journal article
- Publication Details
- Contraception (Stoneham), Vol.93(1), pp.17-24
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.contraception.2015.07.003
- PMID
- 26197261
- PMCID
- PMC4688178
- ISSN
- 0010-7824
- eISSN
- 1879-0518
- Grant note
- DOI: 10.13039/100000200, name: United States Agency for International Development; DOI: 10.13039/100000030, name: Centers for Disease Control and Prevention
- Language
- English
- Date published
- 01/01/2016
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446424102771
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