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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effect of hormonal contraceptive use on HIV progression in female HIV seroconverters in Rakai, Uganda</title><author><name sortKey="Polis, Chelsea B" sort="Polis, Chelsea B" uniqKey="Polis C" first="Chelsea B." last="Polis">Chelsea B. Polis</name><affiliation><nlm:aff id="A1"> Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA</nlm:aff></affiliation></author><author><name sortKey="Wawer, Maria J" sort="Wawer, Maria J" uniqKey="Wawer M" first="Maria J." last="Wawer">Maria J. Wawer</name><affiliation><nlm:aff id="A1"> Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA</nlm:aff></affiliation></author><author><name sortKey="Kiwanuka, Noah" sort="Kiwanuka, Noah" uniqKey="Kiwanuka N" first="Noah" last="Kiwanuka">Noah Kiwanuka</name><affiliation><nlm:aff id="A3"> Makerere University School of Public Health, Kampala, Uganda</nlm:aff></affiliation></author><author><name sortKey="Laeyendecker, Oliver" sort="Laeyendecker, Oliver" uniqKey="Laeyendecker O" first="Oliver" last="Laeyendecker">Oliver Laeyendecker</name><affiliation><nlm:aff id="A4"> Johns Hopkins School of Medicine, Baltimore</nlm:aff></affiliation><affiliation><nlm:aff id="A5"> Laboratory of Immunoregulation, NIAID, NIH, Bethesda, Maryland, USA</nlm:aff></affiliation></author><author><name sortKey="Kagaayi, Joseph" sort="Kagaayi, Joseph" uniqKey="Kagaayi J" first="Joseph" last="Kagaayi">Joseph Kagaayi</name><affiliation><nlm:aff id="A2"> Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe</nlm:aff></affiliation></author><author><name sortKey="Lutalo, Tom" sort="Lutalo, Tom" uniqKey="Lutalo T" first="Tom" last="Lutalo">Tom Lutalo</name><affiliation><nlm:aff id="A2"> Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe</nlm:aff></affiliation></author><author><name sortKey="Nalugoda, Fred" sort="Nalugoda, Fred" uniqKey="Nalugoda F" first="Fred" last="Nalugoda">Fred Nalugoda</name><affiliation><nlm:aff id="A2"> Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe</nlm:aff></affiliation></author><author><name sortKey="Kigozi, Godfrey" sort="Kigozi, Godfrey" uniqKey="Kigozi G" first="Godfrey" last="Kigozi">Godfrey Kigozi</name><affiliation><nlm:aff id="A2"> Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe</nlm:aff></affiliation></author><author><name sortKey="Serwadda, David" sort="Serwadda, David" uniqKey="Serwadda D" first="David" last="Serwadda">David Serwadda</name><affiliation><nlm:aff id="A3"> Makerere University School of Public Health, Kampala, Uganda</nlm:aff></affiliation></author><author><name sortKey="Gray, Ronald H" sort="Gray, Ronald H" uniqKey="Gray R" first="Ronald H." last="Gray">Ronald H. Gray</name><affiliation><nlm:aff id="A1"> Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">20502314</idno><idno type="pmc">2939866</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2939866</idno><idno type="RBID">PMC:2939866</idno><idno type="doi">10.1097/QAD.0b013e32833b3282</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">001081</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001081</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Effect of hormonal contraceptive use on HIV progression in female HIV seroconverters in Rakai, Uganda</title><author><name sortKey="Polis, Chelsea B" sort="Polis, Chelsea B" uniqKey="Polis C" first="Chelsea B." last="Polis">Chelsea B. Polis</name><affiliation><nlm:aff id="A1"> Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA</nlm:aff></affiliation></author><author><name sortKey="Wawer, Maria J" sort="Wawer, Maria J" uniqKey="Wawer M" first="Maria J." last="Wawer">Maria J. Wawer</name><affiliation><nlm:aff id="A1"> Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA</nlm:aff></affiliation></author><author><name sortKey="Kiwanuka, Noah" sort="Kiwanuka, Noah" uniqKey="Kiwanuka N" first="Noah" last="Kiwanuka">Noah Kiwanuka</name><affiliation><nlm:aff id="A3"> Makerere University School of Public Health, Kampala, Uganda</nlm:aff></affiliation></author><author><name sortKey="Laeyendecker, Oliver" sort="Laeyendecker, Oliver" uniqKey="Laeyendecker O" first="Oliver" last="Laeyendecker">Oliver Laeyendecker</name><affiliation><nlm:aff id="A4"> Johns Hopkins School of Medicine, Baltimore</nlm:aff></affiliation><affiliation><nlm:aff id="A5"> Laboratory of Immunoregulation, NIAID, NIH, Bethesda, Maryland, USA</nlm:aff></affiliation></author><author><name sortKey="Kagaayi, Joseph" sort="Kagaayi, Joseph" uniqKey="Kagaayi J" first="Joseph" last="Kagaayi">Joseph Kagaayi</name><affiliation><nlm:aff id="A2"> Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe</nlm:aff></affiliation></author><author><name sortKey="Lutalo, Tom" sort="Lutalo, Tom" uniqKey="Lutalo T" first="Tom" last="Lutalo">Tom Lutalo</name><affiliation><nlm:aff id="A2"> Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe</nlm:aff></affiliation></author><author><name sortKey="Nalugoda, Fred" sort="Nalugoda, Fred" uniqKey="Nalugoda F" first="Fred" last="Nalugoda">Fred Nalugoda</name><affiliation><nlm:aff id="A2"> Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe</nlm:aff></affiliation></author><author><name sortKey="Kigozi, Godfrey" sort="Kigozi, Godfrey" uniqKey="Kigozi G" first="Godfrey" last="Kigozi">Godfrey Kigozi</name><affiliation><nlm:aff id="A2"> Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe</nlm:aff></affiliation></author><author><name sortKey="Serwadda, David" sort="Serwadda, David" uniqKey="Serwadda D" first="David" last="Serwadda">David Serwadda</name><affiliation><nlm:aff id="A3"> Makerere University School of Public Health, Kampala, Uganda</nlm:aff></affiliation></author><author><name sortKey="Gray, Ronald H" sort="Gray, Ronald H" uniqKey="Gray R" first="Ronald H." last="Gray">Ronald H. Gray</name><affiliation><nlm:aff id="A1"> Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA</nlm:aff></affiliation></author></analytic><series><title level="j">AIDS (London, England)</title><idno type="ISSN">0269-9370</idno><idno type="eISSN">1473-5571</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">To assess the association between hormonal contraceptive use and HIV progression.</p></sec><sec id="S2"><title>Design</title><p id="P2">A retrospective analysis of 625 female HIV seroconverters from a Ugandan cohort study.</p></sec><sec sec-type="methods" id="S3"><title>Methods</title><p id="P3">Multivariate Cox regression analyses incorporating time-varying hormonal contraceptive exposure were used to estimate the adjusted hazard ratios of death, and a composite outcome of AIDS or death, associated with hormonal contraceptive use. Sensitivity analyses included lagging hormonal contraceptive exposure, varying comparison groups, and separately assessing effects of oral and injectable contraceptives.</p></sec><sec id="S4"><title>Results</title><p id="P4">A total of 27.5% of women reported ever using hormonal contraception. Of 625 women, 104 (16.6%) died and 291 (46.6%) progressed to AIDS or death during observation. Time-varying hormonal contraceptive use was not associated with an increased hazard of death as compared with nonuse of hormonal contraception (adjusted hazard ratio 0.76, 95% confidence interval 0.41–1.39, <italic>P</italic> = 0.37), and was associated with a significantly reduced hazard of progression to AIDS or death (adjusted hazard ratio 0.70, 95% confidence interval 0.50–0.97, <italic>P</italic> = 0.03). None of the sensitivity analyses suggested an adverse effect of hormonal contraception on HIV progression.</p></sec><sec id="S5"><title>Conclusion</title><p id="P5">Hormonal contraceptive use was not associated with faster progression to death, and was associated with a reduced hazard of progression to the composite outcome of AIDS or death.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8710219</journal-id><journal-id journal-id-type="pubmed-jr-id">1493</journal-id><journal-id journal-id-type="nlm-ta">AIDS</journal-id><journal-title>AIDS (London, England)</journal-title><issn pub-type="ppub">0269-9370</issn><issn pub-type="epub">1473-5571</issn></journal-meta><article-meta><article-id pub-id-type="pmid">20502314</article-id><article-id pub-id-type="pmc">2939866</article-id><article-id pub-id-type="doi">10.1097/QAD.0b013e32833b3282</article-id><article-id pub-id-type="manuscript">NIHMS233292</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Effect of hormonal contraceptive use on HIV progression in female HIV seroconverters in Rakai, Uganda</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Polis</surname><given-names>Chelsea B.</given-names></name><xref rid="A1" ref-type="aff">a</xref></contrib><contrib contrib-type="author"><name><surname>Wawer</surname><given-names>Maria J.</given-names></name><xref rid="A1" ref-type="aff">a</xref></contrib><contrib contrib-type="author"><name><surname>Kiwanuka</surname><given-names>Noah</given-names></name><xref rid="A3" ref-type="aff">c</xref></contrib><contrib contrib-type="author"><name><surname>Laeyendecker</surname><given-names>Oliver</given-names></name><xref rid="A4" ref-type="aff">d</xref><xref rid="A5" ref-type="aff">e</xref></contrib><contrib contrib-type="author"><name><surname>Kagaayi</surname><given-names>Joseph</given-names></name><xref rid="A2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Lutalo</surname><given-names>Tom</given-names></name><xref rid="A2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Nalugoda</surname><given-names>Fred</given-names></name><xref rid="A2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Kigozi</surname><given-names>Godfrey</given-names></name><xref rid="A2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Serwadda</surname><given-names>David</given-names></name><xref rid="A3" ref-type="aff">c</xref></contrib><contrib contrib-type="author"><name><surname>Gray</surname><given-names>Ronald H.</given-names></name><xref rid="A1" ref-type="aff">a</xref></contrib></contrib-group><aff id="A1"><label>a</label> Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA</aff><aff id="A2"><label>b</label> Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe</aff><aff id="A3"><label>c</label> Makerere University School of Public Health, Kampala, Uganda</aff><aff id="A4"><label>d</label> Johns Hopkins School of Medicine, Baltimore</aff><aff id="A5"><label>e</label> Laboratory of Immunoregulation, NIAID, NIH, Bethesda, Maryland, USA</aff><author-notes><corresp id="FN1">Correspondence to Chelsea Polis, 615 North Wolfe St, Baltimore, MD 21205, USA. <email>cpolis@jhsph.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>2</day><month>9</month><year>2010</year></pub-date><pub-date pub-type="ppub"><day>31</day><month>7</month><year>2010</year></pub-date><pub-date pub-type="pmc-release"><day>15</day><month>9</month><year>2010</year></pub-date><volume>24</volume><issue>12</issue><fpage>1937</fpage><lpage>1944</lpage><abstract><sec id="S1"><title>Objective</title><p id="P1">To assess the association between hormonal contraceptive use and HIV progression.</p></sec><sec id="S2"><title>Design</title><p id="P2">A retrospective analysis of 625 female HIV seroconverters from a Ugandan cohort study.</p></sec><sec sec-type="methods" id="S3"><title>Methods</title><p id="P3">Multivariate Cox regression analyses incorporating time-varying hormonal contraceptive exposure were used to estimate the adjusted hazard ratios of death, and a composite outcome of AIDS or death, associated with hormonal contraceptive use. Sensitivity analyses included lagging hormonal contraceptive exposure, varying comparison groups, and separately assessing effects of oral and injectable contraceptives.</p></sec><sec id="S4"><title>Results</title><p id="P4">A total of 27.5% of women reported ever using hormonal contraception. Of 625 women, 104 (16.6%) died and 291 (46.6%) progressed to AIDS or death during observation. Time-varying hormonal contraceptive use was not associated with an increased hazard of death as compared with nonuse of hormonal contraception (adjusted hazard ratio 0.76, 95% confidence interval 0.41–1.39, <italic>P</italic> = 0.37), and was associated with a significantly reduced hazard of progression to AIDS or death (adjusted hazard ratio 0.70, 95% confidence interval 0.50–0.97, <italic>P</italic> = 0.03). None of the sensitivity analyses suggested an adverse effect of hormonal contraception on HIV progression.</p></sec><sec id="S5"><title>Conclusion</title><p id="P5">Hormonal contraceptive use was not associated with faster progression to death, and was associated with a reduced hazard of progression to the composite outcome of AIDS or death.</p></sec></abstract><kwd-group><kwd>family planning</kwd><kwd>HIV progression</kwd><kwd>hormonal contraception</kwd><kwd>survival analysis</kwd><kwd>Uganda</kwd></kwd-group><contract-num rid="AI1">ZIA AI000361-28
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