Abstract
Objective
To investigate whether the incidence of HIV infection is higher among sexually active
women using depot medroxyprogesterone acetate (DMPA) or noresthisterone enanthate
(NET-EN) injections for contraception than among women using nonhormonal or no contraception.
Methods
Five hundred and fifty-one initially HIV-negative women were followed up for a total
of 491 person-years. Participants were interviewed, counselled, examined, tested for
HIV and other STIs, and treated, at three monthly intervals for 1 year.
Results
There was no significant association between progestin contraceptive use and HIV infection
(rate ratio 1.1, 95% CI 0.5 to 2.8; log-rank test, p=.73). In proportional hazards
regression, the only significant hazard ratios for HIV acquisition were prevalent
Neisseria gonorrhoea (5.2; 95% CI 1.1 to 23.7, p=.035) and Trichomonas vaginalis (4.8; 95% CI 1.0 to 22.8, p=.049); bacterial vaginosis was marginally significant
(2.8; 95% CI 1.0 to 8.3, p=.057). The adjusted hazard ratios for NET-EN and DMPA were
1.76 (95% CI 0.64 to 4.84) and 0.46 (95% CI 0.06 to 3.79), respectively, relative
to nonuse. Five hundred and twelve of 551 women had one or more confirmed STIs during
the study.
Conclusions
There is no evidence of an association between HIV infection and injectable contraceptives.
Due to the limited power of this study and because similar studies have not included
young women using NET-EN, we recommend that further research be carried out to focus
on the use of NET-EN and HIV acquisition in high risk groups.
Keywords
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Article info
Publication history
Published online: April 06, 2007
Accepted:
February 14,
2007
Received in revised form:
February 14,
2007
Received:
January 7,
2007
Footnotes
���This study was funded by a grant from the Centers for Disease Control and Prevention (CDC), USA.
Identification
Copyright
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
