Evidence map›Paper›PMID 24785951›Full record

Trial reportAIDS (London, England)2014

Pre-exposure prophylaxis for HIV-1 prevention does not diminish the pregnancy prevention effectiveness of hormonal contraception.

Pamela M Murnane, Renee Heffron, Allan Ronald, Elizabeth A Bukusi, Deborah Donnell, Nelly R Mugo, Edwin Were, Andrew Mujugira, James Kiarie, Connie Celum and 2 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in AIDS (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 4 pooled it
4.0field-weighted citation impact, top 6% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 4 syntheses or guidelines pooled it, 44 citations in OpenAlex.

  1. Pooled it
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  4. Pooled it
  5. Trial
  6. Trial
  7. Trial
  8. Trial
  9. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2024
    Article
  10. Article
  11. Review
  12. Article
  13. Review
  14. Article
  15. Observational
  16. Observational
  17. Article
  18. Article
  19. The Importance of Human Immunodeficiency Virus Research for Transgender and Gender-Nonbinary Individuals.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018
    Review
  20. Recent advances in pre-exposure prophylaxis for HIV.BMJ (Clinical research ed.) · 2017
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 3 countries.

Pamela M MurnaneaDepartment of Epidemiology bDepartment of Global Health, University of Washington, Seattle, Washington, USA cUniversity of Manitoba, Department of Internal Medicine, Winnipeg, Canada dCenter for Microbiology Research, Kenya Medical Research Institute eDepartment of Obstetrics & Gynaecology, University of Nairobi fDepartment of Obstetrics & Gynaecology, Kenyatta National Hospital, Nairobi gDepartment of Reproductive Health, Moi University, Eldoret, Kenya hDepartment of Medicine, University of Washington iStatistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Renee Heffron
Allan Ronald
Elizabeth A Bukusi
Deborah Donnell
Nelly R Mugo
Edwin Were
Andrew Mujugira
James Kiarie
Connie Celum
Jared M Baeten
Partners PrEP Study Team
University of Washington · USGTx (United States) · USKenya Medical Research Institute · KEKenyatta National Hospital · KEMoi University · KEUniversity of Manitoba · CAUniversity of Nairobi · KE

Funding

Pediatric HIV-1 in Africa: Pathogenesis and ManagementK24HD054314 · NICHD · UNIVERSITY OF WASHINGTON · PI JOHN-STEWART, GRACE C. · 2006 to 2016
$1.2M
Hormonal contraception, pre-exposure prophylaxis, and HIV-1 protectionR21HD074439 · NICHD · UNIVERSITY OF WASHINGTON · PI BAETEN, JARED · 2013 to 2014
$432k
Antiretroviral periconception HIV prevention for HIV discordant couplesK99HD076679 · NICHD · UNIVERSITY OF WASHINGTON · PI HEFFRON, RENEE A. · 2013 to 2014
$208k
NICHD NIH HHS K24 HD054314NICHD NIH HHS K99 HD076679NICHD NIH HHS K99HD076679NICHD NIH HHS R21 HD074439NICHD NIH HHS R21HD074439
6 · The paper itself

Abstract

backgroundFor women at risk of HIV-1, effective contraception and effective HIV-1 prevention are global priorities. METHODOLOGY: In a clinical trial of pre-exposure prophylaxis (PrEP) for HIV-1 prevention in HIV-1-serodiscordant couples, we estimated the effectiveness of hormonal contraceptives (oral contraceptive pills, injectable depot medroxyprogesterone acetate, and hormonal implants) for pregnancy prevention relative to no contraception among 1785 HIV-1-uninfected women followed up to 36 months. We compared the effectiveness of each method among women assigned PrEP versus placebo. Contraception was not required for participation, but was offered on-site and was recorded monthly; incident pregnancy was determined by monthly urine testing.

resultsFor women using no contraception, overall pregnancy incidence was 15.4% per year. Women reporting oral contraceptive use had comparable pregnancy incidence to women using no contraception, and this lack of contraceptive effectiveness was similar for those assigned PrEP and placebo (17.7 and 10.0% incidence per year, respectively; P-value for difference in effect by PrEP use = 0.24). Women reporting injectable contraception had reduced pregnancy incidence compared to those reporting no contraception, which did not differ by arm (PrEP 5.1%, placebo 5.3% per year; P-value for difference = 0.47). Contraceptive effectiveness was highest among women using implants (pregnancy incidence <1% per year in both arms).

conclusionPrEP had no adverse impact on hormonal contraceptive effectiveness for pregnancy prevention. As seen previously in similar populations, women reporting contraceptive pill use had little protection from pregnancy, possibly due to poor adherence. Injectable or implantable hormonal contraception and PrEP provide effective prevention for pregnancy and HIV-1.

Indexed as

PregnancyAdultContraceptionContraceptive Agents, FemaleFemaleHIV InfectionsHumansIncidenceMalePlacebosPre-Exposure ProphylaxisTreatment OutcomeContraceptive Agents, FemalePlacebos

Identifiers

PMID24785951
PMCPMC4136509
OpenAlexW2088232432

What OpenQuestion holds

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Registered trials

None linked

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.