Incidence of sexually transmitted infections among HIV-infected women using depot medroxyprogesterone acetate contraception.
BACKGROUND
Previous studies suggest that depot medroxyprogesterone acetate (DMPA) is associated with an increased risk of sexually transmitted infection (STI) acquisition. The primary aim of this study was to characterize the potential association between DMPA use and risk of STI acquisition among HIV-infected women.


METHODS
This is a retrospective cohort study among HIV-infected women followed at a university clinic from 1997 to 2005. Medical records were reviewed for demographic data, HIV parameters, self-reported condom use, substance use, duration of follow-up and incident cases of gonorrhea, chlamydial infection and trichomoniasis.


RESULTS
Of 304 HIV-infected women identified, 82 received DMPA and 222 did not. Overall incidence rates of trichomoniasis, chlamydial infection and gonorrhea were 8.4, 4.0 and 3.1 cases per 100 person-years, respectively, with no significant differences between the women receiving or not receiving DMPA.


CONCLUSIONS
In this HIV-infected cohort, STI rates were higher than the general population, yet DMPA use did not appear to enhance the risk of STI acquisition. This latter finding suggests that the concern for STI acquisition should not be a limiting factor in the use of DMPA in HIV-infected women. The implementation of additional secondary prevention strategies remains an important focus in the HIV epidemic.
Overton
Edgar Turner
ET
Division of Infectious Diseases, Washington University School of Medicine, Campus Box 8051, St. Louis, MO 63110-1093, USA. toverton@im.wustl.edu
Shacham
Enbal
E
Singhatiraj
Ekachai
E
Nurutdinova
Diana
D
D000328:Adult; D015331:Cohort Studies; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D004343:Drug Implants; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015994:Incidence; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use*; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000453:epidemiology*
D003271:Contraceptive Agents, Female; D004343:Drug Implants; D017258:Medroxyprogesterone Acetate