A 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
Day, S.; Graham, S.M.; Masese, L.N.; Richardson, B.A.; Kiarie, J.N.; Jaoko, W.; Mandaliya, K.; Chohan, V.; Overbaugh, J.; McClelland, R.S.
Journal of Acquired Immune Deficiency Syndromes 66(4): 452-456
2014
ISSN/ISBN: 1944-7884 PMID: 24798764 DOI: 10.1097/qai.0000000000000187Document Number: 623289
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.