TY - JOUR
T1 - Hormonal contraceptive use and HIV-1 infection in a population-based cohort in Rakai, Uganda
AU - Kiddugavu, Mohammed
AU - Makumbi, Fred
AU - Wawer, Maria J.
AU - Serwadda, David
AU - Sewankambo, Nelson K.
AU - Wabwire-Mangen, Fred
AU - Lutalo, Tom
AU - Meehan, Mary
AU - Xianbin,
AU - Gray, Ronald H.
AU - Kiwanuka, Noah
AU - Kigozi, Godfrey
AU - Nalugoda, Fred
AU - Chen, Michael
AU - Mabirizi, Joseph
AU - Mondo, George E.
PY - 2003/1/24
Y1 - 2003/1/24
N2 - Background: Hormonal contraceptives have been associated with increased risk of HIV acquisition. Methods: The association between hormonal contraception use and HIV acquisition was assessed in a rural community-based cohort in Rakai District, Uganda. A group of 5117 sexually active HIV-negative women were surveyed at 10 month intervals between 1994 and 1999. Information on demographic and sociobehavioral characteristics, use of hormonal contraception (pill and injectable methods), condoms and the number of sexual partners was obtained by home-based interview. HIV incidence rate ratios (IRR) and 95% confidence intervals (CI) associated with hormonal contraception were estimated by multivariate Poisson regression after adjustment for age, condom use, number of sexual partners, marital status, education and history of genital ulcer disease. Results: At one or more interviews, 16.6% of women reported use of hormonal contraceptives and 23.0% reported condom use. HIV incidence was 2.3/100 person-years in hormonal contraceptive users compared with 1.5/100 person-years in non-hormonal contraceptive users (unadjusted IRR, 1.56; 95% CI, 1.00-2.33). After multivariate adjustment, the IRR associated with hormonal contraceptives was reduced to 0.94 (95% CI, 0.53-1.64). The adjusted IRR was 1.12 (95% CI, 0.48-2.56) with oral contraceptive use and 0.84 (95% CI, 0.41-1.72) with injectable methods. Conclusion: Use of hormonal contraception is not associated with HIV acquisition after adjustment for behavioral confounding.
AB - Background: Hormonal contraceptives have been associated with increased risk of HIV acquisition. Methods: The association between hormonal contraception use and HIV acquisition was assessed in a rural community-based cohort in Rakai District, Uganda. A group of 5117 sexually active HIV-negative women were surveyed at 10 month intervals between 1994 and 1999. Information on demographic and sociobehavioral characteristics, use of hormonal contraception (pill and injectable methods), condoms and the number of sexual partners was obtained by home-based interview. HIV incidence rate ratios (IRR) and 95% confidence intervals (CI) associated with hormonal contraception were estimated by multivariate Poisson regression after adjustment for age, condom use, number of sexual partners, marital status, education and history of genital ulcer disease. Results: At one or more interviews, 16.6% of women reported use of hormonal contraceptives and 23.0% reported condom use. HIV incidence was 2.3/100 person-years in hormonal contraceptive users compared with 1.5/100 person-years in non-hormonal contraceptive users (unadjusted IRR, 1.56; 95% CI, 1.00-2.33). After multivariate adjustment, the IRR associated with hormonal contraceptives was reduced to 0.94 (95% CI, 0.53-1.64). The adjusted IRR was 1.12 (95% CI, 0.48-2.56) with oral contraceptive use and 0.84 (95% CI, 0.41-1.72) with injectable methods. Conclusion: Use of hormonal contraception is not associated with HIV acquisition after adjustment for behavioral confounding.
KW - DMPA
KW - HIV
KW - Heterosexual transmission
KW - Hormonal contraceptives
KW - Injectable
KW - Pills
KW - Risk factors
KW - Sexual behavior
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U2 - 10.1097/00002030-200301240-00014
DO - 10.1097/00002030-200301240-00014
M3 - Article
C2 - 12545084
AN - SCOPUS:0037462792
VL - 17
SP - 233
EP - 240
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 2
ER -