ArticleBMC medicine2021
Pregnancies among women living with HIV using contraceptives and antiretroviral therapy in western Kenya: a retrospective, cohort study.
Article in BMC medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 14 citations in OpenAlex.
- User and Provider Experiences with a Digital Health Family Planning Counseling Tool for Women Living with HIV in Kenya.Studies in family planning · 2026Trial
- Analysis approaches to combine error-prone data with a subset of validated data: an application to a multinational study of Kaposi sarcoma and HIV.American journal of epidemiology · 2026Article
- Evaluation of the relationship between the Desire to Avoid Pregnancy Scale and contraceptive use among women living with HIV in western Kenya.Frontiers in global women's health · 2026Article
- Article
- User experiences with a digital health family planning counseling tool for women living with HIV in Kenya.medRxiv : the preprint server for health sciences · 2025Article
- Data validation in multinational observational studies with error-prone data: applying an optimal validation sampling strategy in a study of Kaposi sarcoma and HIV.American journal of epidemiology · 2025Article
- Pharmacokinetic and Clinical Associations Between Doravirine-Containing Antiretroviral Therapy and Injectable and Implantable Hormonal Contraceptive Methods Among Women Living With Human Immunodeficiency Virus in South Africa.The Journal of infectious diseases · 2025Article
- Effectiveness of levonorgestrel implant and depot medroxyprogesterone acetate injectable for women with HIV on efavirenz.AIDS (London, England) · 2025Article
- Ascertainment Conditional Maximum Likelihood for Continuous Outcome Under Two-Phase Response-Selective Design.Statistics in medicine · 2025Article
- Case Identification of Depression in Inpatient Electronic Medical Records: Scoping Review.JMIR medical informatics · 2024Article
- Three-phase generalized raking and multiple imputation estimators to address error-prone data.Statistics in medicine · 2024Article
- Contraceptive implant use duration is not associated with breakthrough pregnancy among women living with HIV and using efavirenz: a retrospective, longitudinal analysis.Journal of the International AIDS Society · 2022Article
- Preferences for Multipurpose Technology and Non-oral Methods of Antiretroviral Therapy Among Women Living With HIV in Western Kenya: A Survey Study.Frontiers in global women's health · 2022Article
- Assessing the capacity and findings of routine programmatic data in Kenya to guide decision-making around contraceptives and antiretroviral therapy.BMC medicine · 2021Article
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundPreventing unintended pregnancies is paramount for women living with HIV (WLHIV). Previous studies have suggested that efavirenz-containing antiretroviral therapy (ART) reduces contraceptive effectiveness of implants, but there are uncertainties regarding the quality of the electronic medical record (EMR) data used in these prior studies.
methodsWe conducted a retrospective, cohort study of EMR data from 2011 to 2015 among WLHIV of reproductive age accessing HIV care in public facilities in western Kenya. We validated a large subsample of records with manual chart review and telephone interviews. We estimated adjusted incidence rate ratios (aIRRs) with Poisson regression accounting for the validation sampling using inverse probability weighting and generalized raking.
resultsA total of 85,324 women contributed a total of 170,845 women-years (w-y) of observation time; a subset of 5080 women had their charts reviewed, and 1285 underwent interviews. Among implant users, the aIRR of pregnancy for efavirenz- vs. nevirapine-containing ART was 1.9 (95% CI 1.6, 2.4) using EMR data only and 3.2 (95% CI 1.8, 5.7) when additionally using both chart review and interview validated data. Among efavirenz users, the aIRR of pregnancy for depomedroxyprogesterone acetate (DMPA) vs. implant use was 1.8 (95% CI 1.5, 2.1) in EMR only and 2.4 (95% CI 1.0, 6.1) using validated data.
conclusionPregnancy rates are higher when contraceptive implants are concomitantly used with efavirenz-containing ART, though rates were similar to leading alternative contraceptive methods such as DMPA. Our data provides policymakers, program staff, and WLHIV greater confidence in guiding their decision-making around contraceptive and ART options. Our novel, 3-phase validation sampling provides an innovative tool for using routine EMR data to improve the robustness of data quality.
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