Abstract
OBJECTIVE: To update a 2016 systematic review on hormonal contraception use and HIV acquisition.
METHODS: We searched Pubmed and Embase between 15 January 2016 and 26 June 2019 for longitudinal studies comparing incident HIV infection among women using a hormonal contraceptive method and either non-users or users of another specific hormonal contraceptive method. We extracted information from newly identified studies, assessed study quality, and updated forest plots and meta-analyses.
RESULTS: In addition to 31 previously included studies, five more were identified; three provided higher quality evidence. A randomised clinical trial (RCT) found no statistically significant differences in HIV risk among users of intramuscular depot medroxyprogesterone acetate (DMPA-IM), levonorgestrel implant (LNG implant) or the copper intrauterine device (Cu-IUD). An observational study found no statistically significant differences in HIV risk among women using DMPA, norethisterone enanthate (NET-EN), implants (type not specified) or Cu-IUD. Updated results from a previously included observational study continued to find a statistically significant increased HIV risk with oral contraceptives and DMPA compared with no contraceptive use, and found no association between LNG implant and HIV risk.
CONCLUSIONS: High-quality RCT data comparing use of DMPA, LNG implant and Cu-IUD does not support previous concerns from observational studies that DMPA-IM use increases the risk of HIV acquisition. Use of other hormonal contraceptive methods (oral contraceptives, NET-EN and implants) is not associated with an increased risk of HIV acquisition.
| Original language | English |
|---|---|
| Pages (from-to) | 8-16 |
| Number of pages | 9 |
| Journal | African Journal of Reproductive Health |
| Volume | 46 |
| Issue number | 1 |
| Early online date | 9 Jan 2020 |
| DOIs | |
| Publication status | Published - Jan 2020 |
Keywords
- AFRICAN WOMEN
- RISK
- METAANALYSIS
- Humans
- Adolescent
- Hormonal Contraception/methods
- Adult
- Female
- HIV Infections/diagnosis
- hormonal contraception
- epidemiology
- human immunodeficiency virus
- intrauterine devices
Access to Document
- Curtis_HormonalContraceptionHIV_VOR
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