Population-level impact of hormonal contraception on incidence of HIV infection and pregnancy in women in Durban, South Africa
OBJECTIVE: To estimate the potential impact of using hormonal contraceptives on rates of infection with human immunodeficiency virus type 1 (HIV-1) and pregnancy by theoretically removing the use of hormonal contraceptives from a study population. METHODS: A prospective cohort study included 3704 HI...
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| Format: | Article |
| Language: | English |
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The World Health Organization
2012-10-01
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| Series: | Bulletin of the World Health Organization |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862012001000009&lng=en&tlng=en |
| _version_ | 1797288286124769280 |
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| author | Gita Ramjee Handan Wand |
| author_facet | Gita Ramjee Handan Wand |
| author_sort | Gita Ramjee |
| collection | DOAJ |
| description | OBJECTIVE: To estimate the potential impact of using hormonal contraceptives on rates of infection with human immunodeficiency virus type 1 (HIV-1) and pregnancy by theoretically removing the use of hormonal contraceptives from a study population. METHODS: A prospective cohort study included 3704 HIV-negative women who were enrolled in two biomedical trials that tested two vaginal microbicides (PRO 2000 and Carraguard®) for the prevention of HIV-1 in Durban, South Africa, in 2004-2009. Cox proportional hazards regression models along with partial population attributable risks (PARs) and their 95% confidence intervals (CIs) were calculated to assess the relative population-level impact of the use of hormonal contraceptives on HIV-1 seroconversion rates and on pregnancy rates. FINDINGS: Women who reported using hormonal contraceptives at enrolment in the trial had a higher risk of HIV-1 seroconversion (adjusted hazards ratio: 1.24; 95% CI: 0.97-1.58) than women who reported using other types of contraceptives at enrolment. At the population level, the use of hormonal contraceptives (pills or injectables) at baseline and during study follow-up accounted for approximately 20% (95% CI: 16-22) of HIV-1 seroconversions. However, the partial PAR indicated a relative impact of 12% (95% CI: 9.0-15.7). On the other hand, 72% (95% CI: 66-77) of the pregnancies could have been avoided if all women had used hormonal contraceptives. CONCLUSION: Women using hormonal contraceptives need comprehensive counselling on simultaneous prevention of HIV-1 infection. |
| first_indexed | 2024-03-07T18:47:05Z |
| format | Article |
| id | doaj.art-2bcb4cabfb95436fb4ff60aa7751af46 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T18:47:05Z |
| publishDate | 2012-10-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-2bcb4cabfb95436fb4ff60aa7751af462024-03-02T02:19:58ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862012-10-01901074875510.2471/BLT.12.105700S0042-96862012001000009Population-level impact of hormonal contraception on incidence of HIV infection and pregnancy in women in Durban, South AfricaGita Ramjee0Handan Wand1Medical Research CouncilUniversity of New South WalesOBJECTIVE: To estimate the potential impact of using hormonal contraceptives on rates of infection with human immunodeficiency virus type 1 (HIV-1) and pregnancy by theoretically removing the use of hormonal contraceptives from a study population. METHODS: A prospective cohort study included 3704 HIV-negative women who were enrolled in two biomedical trials that tested two vaginal microbicides (PRO 2000 and Carraguard®) for the prevention of HIV-1 in Durban, South Africa, in 2004-2009. Cox proportional hazards regression models along with partial population attributable risks (PARs) and their 95% confidence intervals (CIs) were calculated to assess the relative population-level impact of the use of hormonal contraceptives on HIV-1 seroconversion rates and on pregnancy rates. FINDINGS: Women who reported using hormonal contraceptives at enrolment in the trial had a higher risk of HIV-1 seroconversion (adjusted hazards ratio: 1.24; 95% CI: 0.97-1.58) than women who reported using other types of contraceptives at enrolment. At the population level, the use of hormonal contraceptives (pills or injectables) at baseline and during study follow-up accounted for approximately 20% (95% CI: 16-22) of HIV-1 seroconversions. However, the partial PAR indicated a relative impact of 12% (95% CI: 9.0-15.7). On the other hand, 72% (95% CI: 66-77) of the pregnancies could have been avoided if all women had used hormonal contraceptives. CONCLUSION: Women using hormonal contraceptives need comprehensive counselling on simultaneous prevention of HIV-1 infection.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862012001000009&lng=en&tlng=en |
| spellingShingle | Gita Ramjee Handan Wand Population-level impact of hormonal contraception on incidence of HIV infection and pregnancy in women in Durban, South Africa Bulletin of the World Health Organization |
| title | Population-level impact of hormonal contraception on incidence of HIV infection and pregnancy in women in Durban, South Africa |
| title_full | Population-level impact of hormonal contraception on incidence of HIV infection and pregnancy in women in Durban, South Africa |
| title_fullStr | Population-level impact of hormonal contraception on incidence of HIV infection and pregnancy in women in Durban, South Africa |
| title_full_unstemmed | Population-level impact of hormonal contraception on incidence of HIV infection and pregnancy in women in Durban, South Africa |
| title_short | Population-level impact of hormonal contraception on incidence of HIV infection and pregnancy in women in Durban, South Africa |
| title_sort | population level impact of hormonal contraception on incidence of hiv infection and pregnancy in women in durban south africa |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862012001000009&lng=en&tlng=en |
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