Open AccessA Prospective Cohort Study of the Effect of Depot Medroxyprogesterone Acetate on Detection of Plasma and Cervical HIV-1 in Women Initiating and Continuing Antiretroviral Therapy
Author(s) -
Summer Day,
Susan M. Graham,
Linnet Masese,
Barbra A. Richardson,
James Kiarie,
Walter Jaoko,
Kishorchandra Mandaliya,
Vrasha Chohan,
Julie Overbaugh,
R. Scott McClelland
Publication year - 2014
Publication title -
journal of acquired immune deficiency syndromes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.162
H-Index - 157
eISSN - 1944-7884
pISSN - 1525-4135
DOI - 10.1097/qai.0000000000000187
Subject(s) - medroxyprogesterone acetate , medicine , odds ratio , confidence interval , medroxyprogesterone , gynecology , prospective cohort study , population , obstetrics , estrogen , environmental health
Depot medroxyprogesterone acetate (DMPA) use among HIV-1-infected women may increase transmission by increasing plasma and genital HIV-1 RNA shedding. We investigated associations between DMPA use and HIV-1 RNA in plasma and cervical secretions. One hundred two women initiated antiretroviral therapy, contributing 925 follow-up visits over a median of 34 months. Compared with visits with no hormonal contraception exposure, DMPA exposure did not increase detection of plasma (adjusted odds ratio: 0.81, 95% confidence interval: 0.47 to 1.39) or cervical HIV-1 RNA (adjusted odds ratio: 1.41, 95% confidence interval: 0.54 to 3.67). Our results suggest that DMPA is unlikely to increase infectivity in HIV-positive women who are adherent to effective antiretroviral therapy.