Hormonal contraception and HIV acquisition: reanalysis using marginal structural modeling.
Hormonal contraceptives are used widely worldwide; their effect on HIV acquisition remains unresolved. We reanalyzed data from the Hormonal Contraception and HIV Study using marginal structural modeling to reduce selection bias due to time-dependent confounding. Replicating our original analysis closely, we found that depo-medroxyprogesterone acetate (DMPA) but not combined oral contraceptive (COC) was associated with increased HIV acquisition. Also, young (18-24 years) but not older women who used DMPA and COCs were at increased HIV risk.
Morrison
Charles S
CS
Behavioral and Biomedical Research Division, Family Health International, Research Triangle Park, North Carolina 27709, USA. cmorrison@fhi.org
Chen
Pai-Lien
PL
Kwok
Cynthia
C
Richardson
Barbra A
BA
Chipato
Tsungai
T
Mugerwa
Roy
R
Byamugisha
Josaphat
J
Padian
Nancy
N
Celentano
David D
DD
Salata
Robert A
RA
D000293:Adolescent; D000328:Adult; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D004812:Epidemiologic Methods; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000009:adverse effects; D055815:Young Adult
D003277:Contraceptives, Oral, Combined; D003278:Contraceptives, Oral, Hormonal; D017258:Medroxyprogesterone Acetate