TY - JOUR
T1 - Preexposure prophylaxis is efficacious for HIV-1 prevention among women using depot medroxyprogesterone acetate for contraception
AU - Heffron, Renee
AU - Mugo, Nelly
AU - Were, Edwin
AU - Kiarie, James
AU - Bukusi, Elizabeth A.
AU - Mujugira, Andrew
AU - Frenkel, Lisa M.
AU - Donnell, Deborah
AU - Ronald, Allan
AU - Celum, Connie
AU - Baeten, Jared M.
AU - Robert, L. F.
AU - Kabwohe, Uganda
AU - Jinja, Uganda
AU - Hendrix, Craig W.
AU - Lingappa, Jairam
AU - McElrath, M. Juliana
AU - Kenya, Eldoret
AU - Fife, Kenneth
AU - Tumwesigye, Elioda
AU - Kampala, Uganda
AU - Elly Katabira, A. R.
AU - Kisumu, Kenya
AU - Mbale, Uganda
AU - Nairobi, Kenya
AU - Ndase, Patrick
AU - Katabira, Elly
AU - Cohen, Craig
AU - Wangisi, Jonathan
AU - Campbell, James
AU - Tappero, Jordan
AU - Thika, Kenya
AU - Tororo, Uganda
AU - Farquhar, Carey
AU - John-Stewart, Grace
AU - Mugo, Nelly Rwamba
N1 - Publisher Copyright:
© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.
PY - 2014
Y1 - 2014
N2 - Objective: To evaluate preexposure prophylaxis (PrEP) efficacy for HIV-1 prevention among women using depot medroxyprogesterone acetate (DMPA) for contraception and men whose HIV-1-infected partners use DMPA. Design: Secondary analysis of data from a randomized placebo-controlled trial of daily oral tenofovir and emtricitabine/tenofovir PrEP among heterosexual Kenyan and Ugandan HIV-1 serodiscordant couples. Methods: PrEP efficacy for HIV-1 prevention was compared among HIV-1-uninfected women using DMPA versus no hormonal contraception and among HIV-1 uninfected men whose HIV-1-infected female partners used DMPA versus no hormonal contraception. Results: Of 4747 HIV-1 serodiscordant couples, 901 HIV-1-uninfected women used DMPA at some point during follow-up, 1422 HIV-1-uninfected women used no hormonal contraception, 1568 HIV-1-uninfected men had female partners who used DMPA, and 2626 men had female partners who used no hormonal contraception. PrEP efficacy estimates for HIV-1 prevention, compared with placebo, were similar among women using DMPA and those using no hormonal contraception (64.7 and 75.5%, adjusted interaction P=0.65). Similarly, for men whose female partners used DMPA, PrEP efficacy did not differ from men whose partners used no hormonal contraception (90.0 versus 81.7%, adjusted interaction P=0.52). Conclusion: PrEP is efficacious for HIV-1 prevention among women using DMPA and men whose partners use DMPA, suggesting PrEP could mitigate the potential increased HIV-1 acquisition and transmission risks that have been associated with DMPA use. Women at risk for HIV-1 choosing DMPA could maintain this contraceptive method and add PrEP to achieve prevention of unintended pregnancy and HIV-1.
AB - Objective: To evaluate preexposure prophylaxis (PrEP) efficacy for HIV-1 prevention among women using depot medroxyprogesterone acetate (DMPA) for contraception and men whose HIV-1-infected partners use DMPA. Design: Secondary analysis of data from a randomized placebo-controlled trial of daily oral tenofovir and emtricitabine/tenofovir PrEP among heterosexual Kenyan and Ugandan HIV-1 serodiscordant couples. Methods: PrEP efficacy for HIV-1 prevention was compared among HIV-1-uninfected women using DMPA versus no hormonal contraception and among HIV-1 uninfected men whose HIV-1-infected female partners used DMPA versus no hormonal contraception. Results: Of 4747 HIV-1 serodiscordant couples, 901 HIV-1-uninfected women used DMPA at some point during follow-up, 1422 HIV-1-uninfected women used no hormonal contraception, 1568 HIV-1-uninfected men had female partners who used DMPA, and 2626 men had female partners who used no hormonal contraception. PrEP efficacy estimates for HIV-1 prevention, compared with placebo, were similar among women using DMPA and those using no hormonal contraception (64.7 and 75.5%, adjusted interaction P=0.65). Similarly, for men whose female partners used DMPA, PrEP efficacy did not differ from men whose partners used no hormonal contraception (90.0 versus 81.7%, adjusted interaction P=0.52). Conclusion: PrEP is efficacious for HIV-1 prevention among women using DMPA and men whose partners use DMPA, suggesting PrEP could mitigate the potential increased HIV-1 acquisition and transmission risks that have been associated with DMPA use. Women at risk for HIV-1 choosing DMPA could maintain this contraceptive method and add PrEP to achieve prevention of unintended pregnancy and HIV-1.
KW - Depot medroxyprogesterone acetate
KW - HIV-1 prevention
KW - Hormonal contraception
KW - Preexposure prophylaxis efficacy
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U2 - 10.1097/QAD.0000000000000493
DO - 10.1097/QAD.0000000000000493
M3 - Article
C2 - 25493602
AN - SCOPUS:84927748449
SN - 0269-9370
VL - 28
SP - 2771
EP - 2776
JO - AIDS
JF - AIDS
IS - 18
ER -