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HIV progression risk reduced with hormonal contraception

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SEATTLE — Hormonal contraception did not accelerate HIV disease progression and was associated with a reduced risk for HIV disease progression, according to researchers from the University of Washington.

“Hormonal contraception is widely used and is very important for women’s health,” researcher Renee Heffron, MPH, a doctoral student in the department of epidemiology at the University of Washington, said during a press conference here. “Results from previous studies have been inconsistent about whether hormonal contraception affects HIV progression in women.”

The prospective study included 2,236 women with HIV infection and baseline CD4 counts of at least 250 cells/mm³. The women were from seven countries in eastern and southern Africa. The researchers compared rates of HIV disease progression between those who were using hormonal contraception and those who were not. The primary outcome of the study was nontraumatic death, initiation of antiretroviral therapy or CD4 decline to less than 200 cells/mm³.

There were 377 HIV disease progression events, for an overall rate of 11.5 events/100 person-years. At enrollment, 14.5% of the women were using injectable contraception and 4.2% were using oral contraception. The rate of HIV disease progression among women using hormonal contraception was 8.54/100 person-years vs. 12.27/100 person-years for women not using hormonal contraception (HR=0.75; 95% CI, 0.56-0.99).

For the subset of women using injectable contraception, the rate of HIV disease progression was 8.58/100 person-years vs. 8.39/100 person-years for the subset of women using oral contraception. Among women with HIV, the risk for CD4 decline to less than 500 cells/mm³ was significantly lower for those using hormonal contraception vs. those who were not (HR=0.26; 95% CI, 0.07-0.97).

Renee Heffron, MPH

“Our findings are reassuring, as they show there is no acceleration of HIV progression in women using injectable hormonal contraception methods and, actually, show a reduced rate of HIV disease progression for these women,” Heffron said. “There were few women in our study using oral methods, so we are unable to definitively conclude the same about oral methods of contraception.”

For more information:

• Heffron R. #21. Presented at: 19th Conference on Retroviruses and Opportunistic Infections; March 5-8, 2012; Seattle.

Disclosure: Ms. Heffron reports no relevant financial disclosures.