AI Article Synopsis
- The study aimed to investigate how hormonal contraceptive use affects HIV disease progression and the effectiveness of antiretroviral treatment (ART) among women in St. Petersburg, Russia.
- During the study, they found no significant increase in disease progression risk or changes in CD4 cell count associated with hormonal contraceptives compared to nonhormonal methods.
- The results suggest that using hormonal contraceptives does not negatively impact HIV progression or treatment efficacy for women already living with HIV.
Article Abstract
Objective: To examine the associations between hormonal contraceptive use and measures of HIV disease progression and antiretroviral treatment (ART) effectiveness.
Study Design: 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 <350 cells/mm(3), 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.
Results: During a total of 5233 months follow-up among participants not using ART with enrollment CD4 ≥350 cells/mm(3) (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.
Conclusion: Hormonal contraceptive use was not significantly associated with measures of HIV disease progression or ART effectiveness among women with prevalent HIV infection.
Implications: Hormonal contraceptive use was not significantly associated with measures of HIV disease progression or ART effectiveness among women with prevalent HIV infection.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688178 | PMC |
| http://dx.doi.org/10.1016/j.contraception.2015.07.003 | DOI Listing |
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