The effects of injectable hormonal contraceptives on HIV seroconversion and on sexually transmitted infections
- 28 January 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in AIDS
- Vol. 26 (3), 375-380
- https://doi.org/10.1097/qad.0b013e32834f990f
Abstract
Objectives: To investigate the association between hormonal contraceptives and risk of HIV-1 seroconversion and prevalence of other sexually transmitted infections. Design: Prospective cohort. Methods: The study population was 2 236 HIV-negative women who were screened in a biomedical intervention trial in Durban, South Africa. The association between the use of hormonal contraceptives and risk of HIV-1 seroconversion was modeled using Cox proportional hazards regression analysis. Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections were assessed using logistic regression models. Results: Hormonal injectables were the most common method of contraceptives (46.47%) followed by condom use (28.04%). Overall, compared with women who reported using condoms or other methods as their preferred form of contraceptive, those who reported using hormonal contraceptives (injectables and oral pills) were less likely to use condoms in their last sexual act. Using hormonal injectables during the study was significantly associated with increased risk for HIV-1 infection [adjusted hazard ratio 1.72, 95% confidence interval (CI) 1.19–2.49, P = 0.005]; hormonal injectables were also significantly associated with higher prevalent of C. trachomatis infections (adjusted odds ratio 2.46, 95% CI 1.52–3.97, P < 0.001). Conclusion: Hormonal injectables are highly effective and well tolerated family planning methods and have played an important role in reducing unplanned pregnancies and maternal and infant mortality. However, they do not protect against HIV-1 and other sexually transmitted infections. This study reinforces the importance of comprehensive contraceptive counseling to women about the importance of dual protection, such as male condoms and hormonal contraceptives use.This publication has 24 references indexed in Scilit:
- PRO2000 vaginal gel for prevention of HIV-1 infection (Microbicides Development Programme 301): a phase 3, randomised, double-blind, parallel-group trialThe Lancet, 2010
- Efficacy of Carraguard for prevention of HIV infection in women in South Africa: a randomised, double-blind, placebo-controlled trialThe Lancet, 2008
- Changes in Contraceptive Method Mix In Developing CountriesInternational Family Planning Perspectives, 2007
- Hormonal contraception and the risk of HIV acquisitionAIDS, 2007
- Prospective study of hormonal contraception and women's risk of HIV infection in South AfricaInternational Journal of Epidemiology, 2006
- Effective use of hormonal contraceptives: Part II: combined hormonal injectables, progestogen-only injectables and contraceptive implantsContraception, 2006
- Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household surveyAIDS, 2005
- Effectiveness of the male latex condom: combined results for three popular condom brands used as controls in randomized clinical trialsContraception, 2004
- The Effectiveness of Condoms in Reducing Heterosexual Transmission of HIVFamily Planning Perspectives, 1999
- Hormonal contraception, vitamin A deficiency, and other risk factors for shedding of HIV-1 infected cells from the cervix and vaginaThe Lancet, 1997