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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0000000000000187
Brief Report: Epidemiology and Prevention

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, Summer MD*; Graham, Susan M. MD, MPH, PhD*,†; Masese, Linnet N. MBChB; Richardson, Barbra A. PhD§,‖,¶; Kiarie, James N. MBChB#; Jaoko, Walter MBChB; Mandaliya, Kishorchandra MBChB**; Chohan, Vrasha BSc*,¶; Overbaugh, Julie PhD; Scott McClelland, R. MD, MPH*,†,‡,‖

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Abstract: 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.

© 2014 by Lippincott Williams & Wilkins


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