Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.
HIV infectivity by contraceptive method from a partner study in northern Thailand.
Int Conf AIDS. 1996 Jul 7-12;11(1):42 (abstract no. Mo.C.572). Unique Identifier : AIDSLINE MED/96921014 Nagachinta T; Duerr A; Gargiullo PM; Yutabutra Y; Wannarat A; Tovanabutra S; Sennan S; Suriyanon V; de Boer M; Celentano DD; Nelson KE; CONRAD, Atlanta, GA, USA. Fax:(770) 488-5965. E-mail:; txn3@ccddrh1.em.cdc.gov.
Abstract:
Objective: To measure HIV male to female infectivity (probability of transmission per intercourse) associated with use of different contraceptive methods or pregnancy in an ongoing partner study in Chiang Mai, Thailand. Methods: The study population includes HIV-positive blood donors and their regular female sexual partners. Female partners had no risk factors for HIV other than sexual exposure to the index male. 92 female partners (30 HIV+, 62 HIV-) with defined exposure periods were included in this analysis, specifically those with partners who tested HIV-positive prior to marriage or had known seroconversion dates. Data collected includes sexual history, 5 year contraceptive history, physical exam including pelvic, laboratory testing for STD, HIV (ELISA with Western blot confirmation) and immunophenotyping. Condom and other barrier users (who were rare) were excluded from this analysis. The probability model used in analysis assumed an independent chance of infection per intercourse, and infectivities were estimated by maximum likelihood. Results: HIV-positive women did not differ from HIV-negative women in terms of age, education, duration of relationship, pregnancy, type and frequency of sexual contact with male index case. 78% used oral contraceptives (OC) some time during the study period, 26% used DMPA (not mutually exclusive). Infectivity did not differ significantly between pregnant women and non-pregnant women using either OCs, DMPA or non-hormonal/no method. Estimated infectivity for the OC group was.0019 plus or minus.0012 per intercourse (95%CI). Estimated infectivity for the DMPA exposures was.0021 plus or minus.0038. Infectivity for the non-hormonal/no method exposures was.0023 plus or minus.0022; that for exposures among pregnant women was.0017 plus or minus.0033. Estimated infectivity did not differ significantly by male CD4 counts within any group. However, the infectivity was slightly higher when male CD4 counts were less than 200 cells compared to when CD4 counts were greater than or equal to 200 cells (P=.77). Conclusions: Analysis of this well-defined, albeit small, data set did not demonstrate statistically significant increases in infectivity associated with hormonal contraceptives. This suggests that increased HIV seropositivity among contraceptors found in studies with undefined exposure characteristics be interpreted cautiously.
Keywords: *HIV Infections/TRANSMISSION 970130
M9716179
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Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.
