Evidence map›Paper›PMID 28437215›Full record

Trial reportJournal of women's health (2002)2017

Contraceptive Use and Pregnancy Incidence Among Women Participating in an HIV Prevention Trial.

Carolyne A Akello, Katherine E Bunge, Clemensia Nakabiito, Brenda G Mirembe, Mary Glenn Fowler, Anupam Mishra, Jeanne Marrazzo, Zvavahera M Chirenje, Connie Celum, Jennifer E Balkus

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of women's health (2002), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 30% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
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

10 authors at 5 institutions in 3 countries.

Carolyne A Akello1 Makerere University-Johns Hopkins University Research Collaboration , Kampala, Uganda .
Katherine E Bunge2 Department of Obstetrics and Gynecology, Magee-Womens Research Institute , Pittsburgh, Pennsylvania.
Clemensia Nakabiito1 Makerere University-Johns Hopkins University Research Collaboration , Kampala, Uganda .
Brenda G Mirembe1 Makerere University-Johns Hopkins University Research Collaboration , Kampala, Uganda .
Mary Glenn Fowler1 Makerere University-Johns Hopkins University Research Collaboration , Kampala, Uganda .
Anupam Mishra4 Department of Biostatistics, University of Washington , Seattle, Washington.
Jeanne Marrazzo5 Department of Medicine, University of Washington , Seattle, Washington.
Zvavahera M Chirenje6 University of Zimbabwe-University of California San Francisco Research Program , Harare, Zimbabwe .
Connie Celum5 Department of Medicine, University of Washington , Seattle, Washington.
Jennifer E Balkus7 Department of Global Health, University of Washington , Seattle, Washington.
University of Washington · USMUJHU Research Collaboration · UGJohns Hopkins University · USMagee-Womens Research Institute · USUniversity of Zimbabwe-University of California San Francisco · ZW

Funding

Microbicide Trials NetworkUM1AI068633 · NIAID · MAGEE-WOMEN'S RES INST AND FOUNDATION · PI HILLIER, SHARON L. · 2011 to 2021
$175.0M
UZ-UCSF CTUUM1AI069436 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ZVAVAHERA MIKE CHIRENJE, LYNDA STRANIX-CHIBANDA · 2012 to 2026
$75.9M
Statistical and Data Management Center (SDMC): Microbicide Trials NetworkUM1AI068615 · NIAID · FRED HUTCHINSON CANCER RESEARCH CENTER · PI BROWN, ELIZABETH RENATA · 2011 to 2021
$66.5M
Laboratory Center (LC): Microbicide Trials NetworkUM1AI106707 · NIAID · MAGEE-WOMEN'S RES INST AND FOUNDATION · PI MELLORS, JOHN W, ROHAN, LISA CENCIA · 2014 to 2021
$27.1M
NIAID NIH HHS UM1 AI068615NIAID NIH HHS UM1 AI068633NIAID NIH HHS UM1 AI069436NIAID NIH HHS UM1 AI106707
6 · The paper itself

Abstract

backgroundRecent HIV prevention trials required use of effective contraceptive methods to fulfill eligibility for enrollment. We compared pregnancy rates in a subset of participants enrolled in the Microbicide Trials Network protocol (MTN-003), a randomized trial of chemoprophylaxis to prevent HIV acquisition among women aged 18-45 years who initiated depot medroxyprogesterone acetate (DMPA) or combined oral contraceptives (COCs) at enrollment, relative to those already using DMPA or COCs.

methodsData were analyzed from MTN-003 participants from Uganda. Before enrollment, information on contraceptive type and initiation date was obtained. Urine pregnancy tests were performed at monthly follow-up visits. Cox proportional hazards models were used to compare pregnancy incidence among new users (initiated ≤60 days before enrollment) and established users (initiated >60 days before enrollment).

resultsOf 322 women enrolled, 296 were COC or DMPA users, 82 (28%) were new users, and 214 (72%) were established users. Pregnancy incidence was higher among new contraceptive users compared to established users (20.70% vs. 10.55%; adjusted hazard ratio [HR] = 1.66; 95% confidence interval [95% CI] 0.93-2.96). Among DMPA users, pregnancy incidence was 10.20% in new users versus 3.48% in established users (HR = 2.56; 95% CI 0.86-7.65). Among new COC users, pregnancy incidence was 42.67% in new users versus 23.67% in established COC users (adjusted HR = 1.74; 95% CI 0.87-3.48).

conclusionsNew contraceptive users, regardless of method, at the Uganda MTN-003 site had an increased pregnancy risk compared to established users, which may be due to contraceptive initiation primarily for trial eligibility. New users may benefit from intensive contraceptive counseling and additional contraceptive options, including longer acting reversible contraceptives.

Indexed as

ChemopreventionAdolescentAdultContraceptionContraception BehaviorContraceptives, Oral, CombinedFemaleHIV InfectionsHumansIncidenceMedroxyprogesterone AcetateMiddle AgedOutcome Assessment, Health CarePregnancyProportional Hazards ModelsUgandaContraceptives, Oral, CombinedMedroxyprogesterone Acetatecontraceptive initiationDMPAHIV preventionhormonal contraceptionoral contraceptionUganda

Identifiers

PMID28437215
PMCPMC5512296
OpenAlexW2589618577

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.