Evidence map›Paper›PMID 36357806›Full record

Trial reportAIDS and behavior2023

Post-randomization Differences in Condomless Vaginal Sex Among Women Randomized to Intramuscular Depot Medroxyprogesterone Acetate Injections, a Copper Intrauterine Device or a Levonorgestrel Implant in the ECHO Trial.

Jennifer Deese, Pai Lien Chen, Xiaoming Gao, Renee Heffron, Marcia Hobbs, Dana Lapple, Heather Jaspan, Ashley Miller, Gonasagrie Nair, Maricianah Onono and 3 more

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in AIDS and behavior, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.4field-weighted citation impact, top 17% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Trial
  4. Contraceptive effects on the cervicovaginal microbiome: Recent evidence including randomized trials.American journal of reproductive immunology (New York, N.Y. : 1989) · 2023
    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

13 authors at 6 institutions in 4 countries.

Jennifer DeeseWomen's Global Health Imperative, Global Public Health Impact Center, RTI International, Research Triangle Park, USA. deeseidepi@yahoo.com.ORCID http://orcid.org/0000-0003-1535-1076
Pai Lien ChenBiostatistics and Data Science, FHI 360, Durham, USA.
Xiaoming GaoBiostatistics and Data Science, FHI 360, Durham, USA.
Renee HeffronDepartment of Global Health and Department of Epidemiology, University of Washington, Seattle, WA, USA.
Marcia HobbsUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Dana LappleUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Heather JaspanSeattle Children's Research Institute, Seattle, WA, USA.
Ashley MillerScience Facilitation, FHI 360, Durham, NC, USA.
Gonasagrie NairCentre for Medical Ethics and Law, Department of Medicine, University of Stellenbosch, Stellenbosch, South Africa.
Maricianah OnonoKenya Medical Research Institute, Nairobi, Kenya.
Thesla Palanee-PhillipsFaculty of Health Sciences, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.
Krishnaveni ReddyFaculty of Health Sciences, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.
Markus J SteinerProduct Development and Introduction, FHI 360, Durham, USA.
Family Health International 360 · USUniversity of North Carolina at Chapel Hill · USUniversity of the Witwatersrand · ZAKenya Medical Research Institute · KEStellenbosch University · ZAUniversity of Washington · US

Funding

Effects of Hormonal Contraceptives on Genital Immunity and HIV SusceptibilityR01HD089831 · NICHD · UNIVERSITY OF WASHINGTON · PI HEFFRON, RENEE A., JASPAN, HEATHER BERYL · 2016 to 2020
$3.0M
Contraceptive Method and HIV RiskR21HD095708 · NICHD · FAMILY HEALTH INTERNATIONAL · PI STEINER, MARKUS J · 2018 to 2019
$380k
NICHD NIH HHS R21 HD095708
6 · The paper itself

Abstract

The Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial found no substantial difference in HIV acquisition risk between women randomised to injectable intramuscular depot medroxyprogesterone acetate (DMPA-IM), copper intrauterine device (Cu-IUD) or the levonorgestrel (LNG) implant. We evaluated post-randomization sexual behavior using an objective marker of condomless vaginal sex in a subset of participants. We conducted a sub-study among 458 ECHO participants at three sites (Cape Town, Johannesburg, Kisumu) to evaluate the frequency of condomless vaginal sex, measured by prostate specific antigen (PSA) detection in vaginal swabs, collected at the month 6 and final visit and the concordance of self-reported condomless vaginal sex with PSA detection, by randomized arm. We compared PSA detection frequency and concordance of PSA and self-reported condomless vaginal sex, by randomized group using Cochran-Mantel-Haenszel tests and adjusted generalized logistic growth curve models. PSA was detected less frequently in the DMPA-IM (16%), compared to the Cu-IUD (21%) and LNG implant (24%) groups, although results were not statistically significant in the unadjusted model when accounting for pre-specified multiple-testing criteria. There were significant differences in PSA detection between the DMPA-IM and LNG-implant groups (odds ratio 0.61 (95% CI 0.40, 0.94) in the adjusted model. There was moderate discordance between self-reported condomless vaginal sex and detection of PSA that was similar across randomized groups. These data suggest that women randomized to Cu-IUD and LNG implant may have had condomless sex more frequently than women randomized to DMPA-IM. The discordance between detectable PSA and self-reported sexual behaviour has important implications for design of future HIV prevention studies.

Indexed as

Contraceptive Agents, FemaleHIV InfectionsIntrauterine Devices, CopperFemaleHumansLevonorgestrelMaleMedroxyprogesterone AcetateProstate-Specific AntigenRandom AllocationSouth AfricaUnsafe SexContraceptive Agents, FemaleLevonorgestrelMedroxyprogesterone AcetateProstate-Specific AntigenContraceptionProstate specific antigenSexual behaviour

Identifiers

PMID36357806
PMCPMC9945058
OpenAlexW4308703307

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.