ArticleAIDS (London, England)2013
Modelling the global competing risks of a potential interaction between injectable hormonal contraception and HIV risk.
Article in AIDS (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02905890 (Hormonal Contraception and Bacterial Vaginosis), which is not on this map. Cited by 37 papers, 3 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.
Hormonal Contraception and Bacterial Vaginosis (HCBV): The Effect of Norethisterone Enanthate on Recurrent Bacterial Vaginosis Among Women at High Risk for HIV Infection in Kampala, Uganda
Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- An updated systematic review of epidemiological evidence on hormonal contraceptive methods and HIV acquisition in women.AIDS (London, England) · 2016Pooled it
- Hormonal contraceptive use and women's risk of HIV acquisition: a meta-analysis of observational studies.The Lancet. Infectious diseases · 2015Pooled it
- Guideline
- Use of contraceptive depot medroxyprogesterone acetate is associated with impaired cervicovaginal mucosal integrity.The Journal of clinical investigation · 2018Trial
- Preexposure prophylaxis is efficacious for HIV-1 prevention among women using depot medroxyprogesterone acetate for contraception.AIDS (London, England) · 2014Trial
- Spatial transcriptomics unveils estrogen-modulated immune responses and structural alterations in the ectocervical mucosa of depot medroxyprogesterone acetate users.Scientific reports · 2025Article
- Glucocorticoids and medroxyprogesterone acetate synergize with inflammatory stimuli to selectively upregulate CCL20 transcription.Molecular and cellular endocrinology · 2023Article
- Hidradenitis Suppurativa in Patients with HIV: A Scoping Review.Biomedicines · 2022Article
- Reproductive tract immune cells from pregnant women or those using depot medroxyprogesterone acetate show no excess susceptibility to HIV-1: Results of an ex vivo fusion assay.Contraception · 2021Article
- Estradiol Enhances Antiviral CD4Journal of virology · 2020Article
- Responding to the ECHO trial results: modelling the potential impact of changing contraceptive method mix on HIV and reproductive health in South Africa.Journal of the International AIDS Society · 2020Article
- HIV, progestins, genital epithelial barrier function, and the burden of objectivity†.Biology of reproduction · 2020Article
- Is the Injectable Contraceptive Depo-Medroxyprogesterone Acetate (DMPA-IM) Associated with an Increased Risk for HIV Acquisition? The Jury Is Still Out.AIDS research and human retroviruses · 2020Article
- The Need for Policy Change Regarding Progestin-Only Injectable Contraceptives.Journal of women's health (2002) · 2019Article
- Planning for Outcomes (PGlobal health, science and practice · 2019Article
- The contraceptive medroxyprogesterone acetate, unlike norethisterone, directly increases R5 HIV-1 infection in human cervical explant tissue at physiologically relevant concentrations.Scientific reports · 2019Article
- Article
- Uptake and correlates of contraception among postpartum women in Kenya: results from a national cross-sectional survey.Contraception · 2018Article
- Hormonal Contraception and HIV-1 Acquisition: Biological Mechanisms.Endocrine reviews · 2018Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundSome, but not all, observational studies have suggested an increase in the risk of HIV acquisition for women using injectable hormonal contraception (IHC).
methodsWe used country-level data to explore the effects of reducing IHC use on the number of HIV infections, the number of live births and the resulting net consequences on AIDS deaths and maternal mortality for each country.
resultsHigh IHC use coincides with high HIV incidence primarily in southern and eastern Africa. If IHC increases the risk of HIV acquisition, this could generate 27 000-130 000 infections per year globally, 87-88% of which occur in this region. Reducing IHC use could result in fewer HIV infections but also a substantial increase in live births and maternal mortality in countries with high IHC use, high birth rates and high maternal mortality: mainly southern and eastern Africa, South-East Asia, and Central and South America. For most countries, the net impact of reducing IHC use on maternal and AIDS-related deaths is dependent on the magnitude of the assumed IHC-HIV interaction.
conclusionsIf IHC use increases HIV acquisition risk, reducing IHC could reduce new HIV infections; however, this must be balanced against other important consequences, including unintended pregnancy, which impacts maternal and infant mortality. Unless the true effect size approaches a relative risk of 2.19, it is unlikely that reductions in IHC could result in public health benefit, with the possible exception of those countries in southern Africa with the largest HIV epidemics.
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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.