Use of hormonal contraceptives and risk of HIV-1 transmission: a prospective cohort study

摘要: Summary Background Hormonal contraceptives are used widely but their effects on HIV-1 risk unclear. We aimed to assess the association between hormonal contraceptive use and of acquisition by women transmission from HIV-1-infected male partners. Methods In this prospective study, we followed up 3790 heterosexual HIV-1-serodiscordant couples participating in two longitudinal studies incidence seven African countries. Among injectable oral users non-users, compared rates men. The primary outcome measure was seroconversion. Cox proportional hazards regression marginal structural modelling effect risk. Findings 1314 which HIV-1-seronegative partner female (median follow-up 18·0 [IQR 12·6–24·2] months), were 6·61 per 100 person-years who contraception 3·78 those did not (adjusted hazard ratio 1·98, 95% CI 1·06–3·68, p=0·03). 2476 18·7 12·8–24·2] men 2·61 1·51 1·97, 1·12–3·45, p=0·02). Marginal model analyses generated much same results regression. Interpretation Women should be counselled about potentially increased with contraception, especially methods, importance dual protection condoms decrease Non-hormonal or low-dose methods considered for at-risk HIV-1. Funding US National Institutes Health Bill & Melinda Gates Foundation.