Trial reportThe Lancet. Infectious diseases2012
Use of hormonal contraceptives and risk of HIV-1 transmission: a prospective cohort study.
Trial report in The Lancet. Infectious diseases, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 236 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of a Vaginal Contraceptive Ring on Vaginal Microbiota and Local Immunity
Effects of Contraceptive Ring on Vaginal Microbiota, HIV Shedding and Local Immunity
Who cites it
236 citing papers in PubMed, 7 syntheses or guidelines pooled it, 420 citations in OpenAlex.
- Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies.PLoS medicine · 2018Pooled it
- An updated systematic review of epidemiological evidence on hormonal contraceptive methods and HIV acquisition in women.AIDS (London, England) · 2016Pooled it
- Contraception for HIV-Infected Adolescents.Pediatrics · 2016Guideline
- Hormonal contraceptive use and women's risk of HIV acquisition: a meta-analysis of observational studies.The Lancet. Infectious diseases · 2015Pooled it
- Hormonal contraception and the risk of HIV acquisition: an individual participant data meta-analysis.PLoS medicine · 2015Pooled it
- Application of marginal structural models in pharmacoepidemiologic studies: a systematic review.Pharmacoepidemiology and drug safety · 2014Pooled it
- Incident HIV during pregnancy and postpartum and risk of mother-to-child HIV transmission: a systematic review and meta-analysis.PLoS medicine · 2014Pooled it
- Long-Term Follow-up of Levonorgestrel Intrauterine Device for Atypical Hyperplasia and Early Endometrial Cancer Reveals Relapse Characterized by Immune Exhaustion.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024Trial
- Trial
- Systems analysis reveals differential expression of endocervical genes in African women randomized to DMPA-IM, LNG implant or cu-IUD.Clinical immunology (Orlando, Fla.) · 2023Trial
- The Effect of Contraception on Genital Cytokines in Women Randomized to Copper Intrauterine Device, Depot Medroxyprogesterone Acetate, or Levonorgestrel Implant.The Journal of infectious diseases · 2022Trial
- Trial
- Brief Report: HIV Shedding in the Female Genital Tract of Women on ART and Progestin Contraception: Extended Follow-up Results of a Randomized Clinical Trial.Journal of acquired immune deficiency syndromes (1999) · 2019Trial
- Acquisition of Sexually Transmitted Infections among Women Using a Variety of Contraceptive Options: A prospective Study among High-risk African Women.Journal of the International AIDS Society · 2019Trial
- Use of contraceptive depot medroxyprogesterone acetate is associated with impaired cervicovaginal mucosal integrity.The Journal of clinical investigation · 2018Trial
- Effect of the depot medroxyprogesterone acetate injectable and levonorgestrel implant on HIV genital shedding: a randomized trial.Contraception · 2018Trial
- Uptake of hormonal contraceptives and correlates of uptake in a phase III clinical trial in rural South Western Uganda.Reproductive health · 2017Trial
- A randomized clinical trial on the effects of progestin contraception in the genital tract of HIV-infected and uninfected women in Lilongwe, Malawi: Addressing evolving research priorities.Contemporary clinical trials · 2017Trial
- Trial
- Effect of Depot Medoxyprogesterone Acetate on Immune Functions and Inflammatory Markers of HIV-Infected Women.Journal of acquired immune deficiency syndromes (1999) · 2016Trial
176 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 4 countries.
Funding
Abstract
backgroundHormonal contraceptives are used widely but their effects on HIV-1 risk are unclear. We aimed to assess the association between hormonal contraceptive use and risk of HIV-1 acquisition by women and HIV-1 transmission from HIV-1-infected women to their male partners.
methodsIn this prospective study, we followed up 3790 heterosexual HIV-1-serodiscordant couples participating in two longitudinal studies of HIV-1 incidence in seven African countries. Among injectable and oral hormonal contraceptive users and non-users, we compared rates of HIV-1 acquisition by women and HIV-1 transmission from women to men. The primary outcome measure was HIV-1 seroconversion. We used Cox proportional hazards regression and marginal structural modelling to assess the effect of contraceptive use on HIV-1 risk.
findingsAmong 1314 couples in which the HIV-1-seronegative partner was female (median follow-up 18·0 [IQR 12·6-24·2] months), rates of HIV-1 acquisition were 6·61 per 100 person-years in women who used hormonal contraception and 3·78 per 100 person-years in those who did not (adjusted hazard ratio 1·98, 95% CI 1·06-3·68, p=0·03). Among 2476 couples in which the HIV-1-seronegative partner was male (median follow-up 18·7 [IQR 12·8-24·2] months), rates of HIV-1 transmission from women to men were 2·61 per 100 person-years in couples in which women used hormonal contraception and 1·51 per 100 person-years in couples in which women did not use hormonal contraception (adjusted hazard ratio 1·97, 95% CI 1·12-3·45, p=0·02). Marginal structural model analyses generated much the same results to the Cox proportional hazards regression.
interpretationWomen should be counselled about potentially increased risk of HIV-1 acquisition and transmission with hormonal contraception, especially injectable methods, and about the importance of dual protection with condoms to decrease HIV-1 risk. Non-hormonal or low-dose hormonal contraceptive methods should be considered for women with or at-risk for HIV-1.
fundingUS National Institutes of Health and the Bill & Melinda Gates Foundation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.