The evidence on the impact of depot medroxyprogesterone acetate (DMPA), a progestin-only
injectable form of contraception, on increased HIV-1 acquisition is mixed [
[1]
]. A meta-analysis of observational data from 18 studies of over 38,000 women with
1887 incident HIV infections, adjusted for region, age, partner status, time-varying
number of sexual partners and time-varying condom use, suggests that the use of DMPA
increases the risk of HIV-1 acquisition by 1.5 times [95% confidence interval (CI),
1.2–1.8] compared to women not using hormonal contraceptive methods [
[2]
]. Further, a recent, planned secondary analysis of 3163 women from an HIV prevention
trial in Uganda, South Africa and Zimbabwe (the VOICE study) found that DMPA users
had 1.4 times (95% CI 1.0–2.0) the hazard of HIV acquisition compared to users of
norethistoerone enanthate (NET-EN) injectable contraception [
[3]
]. In this study, HIV incidence among DMPA users was 8.0 per 100 woman–years compared
to 5.4 per 100 woman–years among NET-EN users, resulting in 2.6 additional cases of
HIV per 100 woman–years for DMPA users compared to NET-EN users [
[3]
]. Thus, while the findings are mixed, our best estimates are that DMPA use increases
HIV acquisition modestly.To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 02, 2014
Accepted:
May 27,
2014
Received in revised form:
May 12,
2014
Received:
March 31,
2014
Footnotes
☆The author has no conflicts of interest to declare.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
