title: 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.
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.
authors.affiliation: *Department of Medicine, University of Washington, Seattle, WA; †Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya; Departments of ‡Epidemiology; §Biostatistics; ‖Global Health, University of Washington, Seattle WA; ¶Fred Hutchinson Cancer Research Center, Seattle, WA; #Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya; and **Pathcare Laboratories, Mombasa, Kenya.
authors.forename: Summer
authors.initials: S
authors.lastname: Day
authors.forename: Susan M
authors.initials: SM
authors.lastname: Graham
authors.forename: Linnet N
authors.initials: LN
authors.lastname: Masese
authors.forename: Barbra A
authors.initials: BA
authors.lastname: Richardson
authors.forename: James N
authors.initials: JN
authors.lastname: Kiarie
authors.forename: Walter
authors.initials: W
authors.lastname: Jaoko
authors.forename: Kishorchandra
authors.initials: K
authors.lastname: Mandaliya
authors.forename: Vrasha
authors.initials: V
authors.lastname: Chohan
authors.forename: Julie
authors.initials: J
authors.lastname: Overbaugh
authors.forename: R Scott
authors.initials: RS
authors.lastname: McClelland
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002582:Cervix Mucus / Q000821:virology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003692:Delayed-Action Preparations; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D017258:Medroxyprogesterone Acetate / Q000097:blood / Q000494:pharmacology*; D012367:RNA, Viral / Q000032:analysis / Q000097:blood
chemical_list: D019380:Anti-HIV Agents; D003692:Delayed-Action Preparations; D012367:RNA, Viral; D017258:Medroxyprogesterone Acetate