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Is a lower-dose, subcutaneous contraceptive injectable containing depot medroxyprogesterone acetate likely to impact women's risk of HIV?

  • Author Footnotes
    1 All authors contributed equally to the writing of this manuscript.
    Chelsea B. Polis
    Correspondence
    Corresponding author.
    Footnotes
    1 All authors contributed equally to the writing of this manuscript.
    Affiliations
    Guttmacher Institute, New York, NY, USA

    Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, USA
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  • Author Footnotes
    1 All authors contributed equally to the writing of this manuscript.
    Sharon L. Achilles
    Footnotes
    1 All authors contributed equally to the writing of this manuscript.
    Affiliations
    Department of Obstetrics, Gynecology, and Reproductive Sciences and Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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  • Author Footnotes
    1 All authors contributed equally to the writing of this manuscript.
    Zdenek Hel
    Footnotes
    1 All authors contributed equally to the writing of this manuscript.
    Affiliations
    Department of Pathology, Center for AIDS Research, University of Alabama at Birmingham, Birmingham, AL, USA
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  • Author Footnotes
    1 All authors contributed equally to the writing of this manuscript.
    Janet P. Hapgood
    Footnotes
    1 All authors contributed equally to the writing of this manuscript.
    Affiliations
    Department of Molecular and Cell Biology and Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
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  • Author Footnotes
    1 All authors contributed equally to the writing of this manuscript.
      Injectable contraceptives are the most widely used method of contraception in sub-Saharan Africa among married or in-union women aged 15–44 [
      • United Nations
      • Department of Economics and Social Affairs
      • Population Division
      Trends in contraceptive use worldwide 2015 (ST/ESA/SER.A/349).
      ]. Injectable contraceptive use grew more quickly than use of any other contraceptive method between 1994 and 2015: from 2% to 7% of the share of all contraceptive use (among married or in-union women) worldwide, and from 17% to 38% of the share of all contraceptive use in sub-Saharan Africa [
      • United Nations
      • Department of Economics and Social Affairs
      • Population Division
      Trends in contraceptive use worldwide 2015 (ST/ESA/SER.A/349).
      ]. Injectables are quick to administer, highly effective, do not require daily user action, and can be used clandestinely [
      • Adetunji J.A.
      Rising popularity of injectable contraceptives in sub-Saharan Africa.
      ]. Like all contraceptive methods, injectables can empower women and couples to achieve their reproductive goals, reduce unintended pregnancy, and prevent maternal morbidity and mortality [
      • Ahmed S.
      • Li Q.
      • Liu L.
      • Tsui A.O.
      Maternal deaths averted by contraceptive use: an analysis of 172 countries.
      ].
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