Evidence map›Paper›PMID 34587971›Full record

Trial reportReproductive health2021

Behavioral effects of different contraceptive methods and HIV acquisition: an ancillary study of the ECHO randomized trial.

Mandisa Singata-Madliki, Theresa A Lawrie, Yusentha Balakrishna, Florence Carayon-Lefebvre d'Hellencourt, G Justus Hofmeyr

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Reproductive health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.6field-weighted citation impact, top 29% 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, 6 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Trial
  4. Review
  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

5 authors at 3 institutions in 4 countries.

Mandisa Singata-MadlikiEffective Care Research Unit, Frere Maternity Hospital, Eastern Cape Department of Health/Universities of the Witwatersrand and Fort Hare, P.O. Box 4097, East London, South Africa. mandisa.singata@gmail.com.ORCID http://orcid.org/0000-0003-4193-8786
Theresa A LawrieEffective Care Research Unit, Frere Maternity Hospital, Eastern Cape Department of Health/Universities of the Witwatersrand and Fort Hare, P.O. Box 4097, East London, South Africa.ORCID http://orcid.org/0000-0002-5500-8590
Yusentha BalakrishnaBiostatistics Research Unit, South African Medical Research Council, Durban, South Africa.ORCID http://orcid.org/0000-0001-6449-3260
Florence Carayon-Lefebvre d'HellencourtFHI 360, 359 Blackwell St, Suite 200, Durham, NC, 27701, USA.ORCID http://orcid.org/0000-0001-8613-2618
G Justus HofmeyrEffective Care Research Unit, Frere Maternity Hospital, Eastern Cape Department of Health/Universities of the Witwatersrand and Fort Hare, P.O. Box 4097, East London, South Africa.ORCID http://orcid.org/0000-0002-3080-1007
Western Cape Department of Health · ZAFamily Health International 360 · USSouth African Medical Research Council · ZA

Funding

Bill & Melinda Gates Foundation INV-006860
6 · The paper itself

Abstract

backgroundThe ECHO trial randomised 7829 women to depot medroxyprogesterone acetate (DMPA-IM), the copper intrauterine device (IUD) and the levonorgestrel (LNG) implant (1:1:1) and found no clear difference in HIV incidence between these three groups. We have previously hypothesized that oligo-amenorrhoea induced by DMPA-IM may have a protective effect on HIV acquisition. The aim of this ancillary study was to assess the effects of DMPA-IM, the IUD and the LNG implant on menstrual symptoms and sexual behavior and to correlate these with HIV acquisition.

methodsAt the Effective Care Research Unit (ECRU) in South Africa, of 615 women already randomised to DMPA-IM, the copper IUD and the LNG implant (1:1:1) 552 agreed to participate. Participants completed a 28-day symptom and behavior diary following their one-month ECHO trial visit and returning it at their 3-month follow-up visit. HIV acquisition data were retrieved from ECHO trial records.

resultsOf 552 women enrolled on the ancillary study, 390 (70.6%) completed their daily diary; 130, 133, and 127 received DMPA-IM, IUD, and LNG implant, respectively. Thirty-three (5.9%) of these women acquired HIV. Women on the progestin-only contraceptives were more likely to experience amenorrhoea, as expected, and were less likely to have intra-menstrual coitus than IUD users (p < 0.001 for DMPA-IM vs IUD and p = 0.002 for implant vs IUD). Overall coital frequency was highest and condom usage lowest among DMPA-IM users. Intra-menstrual coitus correlated positively, and duration of menstruation correlated negatively, with HIV acquisition, although these effects were not statistically significant (p = 0.09 and p = 0.079, respectively).

conclusionsFindings support the hypothesis that oligo-amenorrhoea and the associated reduced intra-menstrual coitus may mitigate the potential for an increased biological risk of HIV acquisition with DMPA-IM but more evidence is needed. Study registration number PACTR201706001651380.

Indexed as

Contraceptive Agents, FemaleHIV InfectionsIntrauterine Devices, CopperContraceptionFemaleHumansLevonorgestrelProgestinsContraceptive Agents, FemaleLevonorgestrelProgestinsCondomContraceptionDMPAHIVIntrauterine deviceLNG implantMenstruationSexual behavior

Identifiers

PMID34587971
PMCPMC8480042
OpenAlexW3204682463

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.