HIV Risk Does Not Differ With Three Contraceptive Methods

For African women seeking effective contraception, there is no significant difference in HIV incidence with use of intramuscular depot medroxyprogesterone acetate (DMPA-IM), a copper intrauterine device (IUD), and a levonorgestrel (LNG) implant, according to a study published online June 13 in The Lancet.

Jared M. Baeten, M.D., from the University of Washington in Seattle, and colleagues conducted a randomized multicenter trial involving HIV-seronegative women aged 16 to 35 years who were seeking effective contraception. The modified intention-to-treat population included 7,715 participants who were randomly assigned to receive an injection of 150 mg/mL DMPA-IM every three months (2,556 women), a copper IUD (2,571 women), or an LNG implant (2,588 women).

The researchers identified 397 HIV infections (incidence, 3.81 per 100 woman-years): 143 (4.19 per 100 woman-years), 138 (3.94 per 100 woman-years), and 116 (3.31 per 100 woman-years) in the DMPA-IM, IUD, and LNG implant groups, respectively. The hazard ratios for HIV acquisition were 1.04 for DMPA-IM versus IUD; 1.23 for DMPA-IM versus LNG implant; and 1.18 for IUD versus LNG implant.

"This randomized trial did not find a substantial difference in HIV risk among the methods evaluated, and all methods were safe and highly effective," the authors write. "These results underscore the importance of continued and increased access to these three contraceptive methods."

One author disclosed financial ties to the pharmaceutical industry.

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