Www.ias2015.org Effectiveness of Contraception for HIV-Infected Women using Antiretroviral Therapy Maria Pyra a,b, Renee Heffron a,b, Nelly R. Mugo b,d,e,

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Presentation transcript:

Effectiveness of Contraception for HIV-Infected Women using Antiretroviral Therapy Maria Pyra a,b, Renee Heffron a,b, Nelly R. Mugo b,d,e, Kavita Nanda f, Katherine K. Thomas a, Connie Celum a,b,c, Athena P. Kourtis g, Jared M. Baeten a,b,c for the Partners in Prevention HSV/HIV Transmission Study and Partners PrEP Study Teams a Department of Epidemiology, b Department of Global Health, c Department of Medicine, University of Washington, Seattle, Washington, USA; d Department of Obstetrics & Gynaecology, University of Nairobi, e Sexual, Reproductive, Adolescent and Child Health Research Program, Kenya Medical Research Institute, Nairobi, Kenya; f FHI 360, Integrated Health Sciences, Research Triangle Park, North Carolina, USA; g Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Question: Does effectiveness of hormonal contraception (implant, injectable, oral pill) differ by ART use? Sample: 5,153 women (1,376 pregnancies) in serodiscordant couples from 3 prospective studies in Africa  Partners in Prevention HSV/HIV Transmission Study  Couples Observation Study  Partners PrEP Study Characteristics:  Young (median age 29), healthy (51% CD4>500), and ART naïve at enrollment  Median follow-up 1.8 years  24% became pregnant and 31% ever took ART Analysis: Cox proportional hazard models with repeated outcomes (pregnancy)  Tested interactions between ART use and contraceptive method

Results 95% 94% 80% 82% 64% 63% p=0.73 p=0.79p=0.97 Results were no different when limited to women using NVP.When limited to EFV (206 person-years), all methods showed reduced effectiveness: 57% for implants, 71% for injectables, and 14% for OC. However, there was no statistically significant difference between women on EFV compared to no ART for each method. In conclusion, hormonal contraception, especially implants and injectables, remain effective for HIV+ women taking ARTs. Data on real-world hormonal contraception effectiveness are important in determining family planning guidelines for women with HIV. Note: Arrows represent adjusted hazard ratios. For all three methods of hormonal contraception, there were no significant differences in the adjusted hazard ratios by ART use.