Hormonal contraception decreases bacterial vaginosis but oral contraception may increase candidiasis: implications for HIV transmission.

摘要: Objective A 2012 WHO consultation concluded that combined oral contraception (COC) does not increase HIV acquisition in women, but the evidence for depot medroxyprogesterone acetate (DMPA) is conflicting. We evaluated effect of COC and DMPA use on vaginal microbiome because current suggests any deviation from a 'healthy' increases women's susceptibility to HIV. Methods conducted systematic review reanalysed Hormonal Contraception Acquisition (HC-HIV) study. Vaginal outcomes included bacterial vaginosis by Nugent scoring, candidiasis culture or KOH wet mount compositions as characterized molecular techniques. Results Our 36 eligible studies found reduce 10-20 18-30%, respectively. The HC-HIV data showed also intermediate microbiota (Nugent score 4-6) 11% each. In contrast, (but use) may candidiasis. Molecular (n=4) confirm high oestrogen levels favour composition dominated Lactobacillus species; effects progesterone are less clear well studied. Conclusion risk increasing predispose candidiasis, believed be associated with increased acquisition. However, potential role Candida species, imbalances other than transmission cannot yet ruled out. Further in-depth needed.