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

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dc.contributor.authorAkello, Carolyne A
dc.contributor.authorBunge, Katherine E
dc.contributor.authorNakabiito, Clemensia
dc.contributor.authorMirembe, Brenda G
dc.contributor.authorFowler, Mary Glenn
dc.contributor.authorMishra, Anupam
dc.contributor.authorMarrazzo, Jeanne
dc.contributor.authorChirenje, Zvavahera M
dc.contributor.authorCelum, Connie
dc.contributor.authorBalkus, Jennifer E
dc.date.accessioned2021-12-13T06:49:21Z
dc.date.available2021-12-13T06:49:21Z
dc.date.issued2017
dc.description.abstractBackground: Recent 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. Methods: Data 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). Results: Of 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). Conclusions: New 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.en_US
dc.identifier.citationAkello, C. A., Bunge, K. E., Nakabiito, C., Mirembe, B. G., Fowler, M. G., Mishra, A., ... & Balkus, J. E. (2017). Contraceptive use and pregnancy incidence among women participating in an HIV prevention trial. Journal of Women's Health, 26(6), 670-676.DOI: 10.1089/jwh.2016.5958en_US
dc.identifier.other10.1089/jwh.2016.5958
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/382
dc.language.isoenen_US
dc.publisherJournal of Women's Healthen_US
dc.subjectHormonal contraceptionen_US
dc.subjectContraceptive initiationen_US
dc.subjectDMPAen_US
dc.subjectOral contraceptionen_US
dc.subjectUgandaen_US
dc.subjectHIV preventionen_US
dc.titleContraceptive Use and Pregnancy Incidence Among Women Participating in an HIV Prevention Trialen_US
dc.typeArticleen_US
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