Preference for Sayana® Press versus intramuscular Depo-Provera among HIV-positive women in Rakai, Uganda: A randomized crossover trial

Chelsea B. Polis, Gertrude F. Nakigozi, Hadijja Nakawooya, George Mondo, Fredrick Makumbi, Ronald H. Gray

Research output: Contribution to journalArticle

Abstract

Introduction Sayana Press (SP), a subcutaneous formulation of depot medroxyprogesterone acetate (DMPA) prefilled in a Uniject injection system, could potentially improve and expand contraceptive injection services, but acceptability of SP is unknown. HIV-positive women need contraception to avoid unintended pregnancy and risk of vertical HIV transmission. We assessed acceptability of SP versus intramuscular DMPA (DMPA-IM) among HIV-positive women and their care providers in Rakai, Uganda. Methods Women were randomized to DMPA-IM or SP at baseline, received the alternate product at 3 months, and chose their preferred method at 6 months. We determined preferences among new and experienced contraceptive injectable users who had tried both types of injection during the trial, and from providers before and after providing both types of injectables to clients. Results Among 357 women randomized, 314 were followed up at 6 months (88%). Although SP caused more skin irritation than DMPA-IM (3.8% vs. 0% at 6 months, p=.03), it was associated with marginally fewer side effects (30.4% vs. 40.4% at 6 months, p=.06). Participants reported high levels of willingness to recommend the DMPA contraception to a friend and satisfaction with the injection received, and these did not differ by injection type. Sixty-four percent of women and 73% of providers preferred SP to DMPA-IM at 6 months; women's preferences did not differ by previous experience with injectable contraception. Conclusions SP is acceptable to HIV-positive women and health care providers in this rural Ugandan population. Implications SP appears to be acceptable to HIV-positive women and their care providers in Rakai, Uganda, and strategies for appropriate rollout of this innovative technology should be explored.

Original languageEnglish (US)
Pages (from-to)385-395
Number of pages11
JournalContraception
Volume89
Issue number5
DOIs
StatePublished - May 2014

Keywords

  • Acceptability
  • Contraception
  • Injectable
  • Intramuscular
  • Subcutaneous

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Fingerprint Dive into the research topics of 'Preference for Sayana® Press versus intramuscular Depo-Provera among HIV-positive women in Rakai, Uganda: A randomized crossover trial'. Together they form a unique fingerprint.

  • Cite this