Hormonal contraception and risk of cervical infections among HIV-1-seropositive Kenyan women
Hormonal contraception and risk of cervical infections among HIV-1-seropositive Kenyan women
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DOI：
10.1097/00002030-200411050-00010
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发表时间：
2004-11-05
期刊：
影响因子：
3.8
通讯作者：
Baeten, JM
中科院分区：
文献类型：
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作者：
Lavreys, L;Chohan, V;Baeten, JM
目的：探讨HIV-1感染妇女中激素性避孕措施的使用与宫颈性病感染的关系。设计：对肯尼亚蒙巴萨242名暗娼进行前瞻性队列研究，追踪HIV-1感染时间。方法：每月随访一次，记录性行为和避孕使用情况，并进行实验室STI筛查。建立多因素Andersen-Gill比例风险模型，以检验激素避孕措施的使用与宫颈STI的发生之间的关系。结果：HIV-1感染后的中位随访时间为35个月，累计随访799人年。在调整人口学因素和性行为后，与未使用避孕药的妇女相比，使用注射避孕药的妇女患沙眼衣原体感染[危险比(HR)3.1，95%可信区间(CI)1.0~9.4，P=0.05]和宫颈炎症(HR 1.6，95%CI 1.0~2.3，P=0.03)的风险增加。口服避孕药的使用增加了宫颈炎症的风险(HR 2.3，95%CI 1.4-3.8，P=0.001)。激素避孕与淋球菌感染风险的增加无关。结论：HIV-1感染妇女使用激素避孕与宫颈炎症和衣原体感染的风险增加相关。使用激素避孕的HIV-1血清阳性妇女应该被告知持续使用避孕套的重要性，以防止STI和HIV-1的传播。(C)2004年，里平科特·威廉姆斯·威尔金斯。
Objective: To evaluate the relationship between hormonal contraceptive use and the acquisition of cervical sexually transmitted infections (STI) among HIV-1-infected women.Design: A prospective cohort study of 242 commercial sex workers in Mombasa, Kenya, followed from the time of HIV-1 infection.Methods: At monthly follow-up visits, sexual behavior and contraceptive use were recorded, and laboratory screening for STI was performed. Multivariate Andersen-Gill proportional hazards models were constructed to examine the association between the use of hormonal contraception and the occurrence of cervical STI.Results: The median duration of follow-up after HIV-1 acquisition was 35 months, and 799 person-years of follow-up were accrued. After adjustment for demographic factors and sexual behavior, women using the injectable contraceptive depot medroxyprogesterone acetate were at increased risk of Chlamydia trachomatis infection [hazard ratio (HR) 3.1, 95% confidence interval (CI) 1.0-9.4, P = 0.05] and cervicitis (HR 1.6, 95% CI 1.0-2.3, P = 0.03) compared with women using no contraception. The use of oral contraceptive pills was associated with an increased risk of cervicitis (HR 2.3, 95% CI 1.4-3.8, P = 0.001). Hormonal contraception was not associated with an increased risk of infection with Neisseria gonorrhoeae.Conclusion: The use of hormonal contraception by HIV-1-infected women was associated with an increased risk of cervicitis and cervical chlamydia infection. HIV-1 seropositive women using hormonal contraception should be counseled about the importance of consistent condom use to prevent both STI and HIV-1 transmission. (C) 2004 Lippincott Williams Wilkins.