OBJECTIVE: To evaluate contraceptive adherence to the copper intrauterine device (Cu-IUD) and the injectable depot medroxyprogesterone acetate (DMPA) among women with HIV in Lilongwe, Malawi. METHODS: We randomized 200 HIV-infected women on highly active antiretroviral therapy (HAART) to either theCu-IUD or DMPA and followed these women prospectively, evaluating adherence and factors associated with nonadherence. RESULTS: There was no difference in contraceptive adherence: 68% of Cu-IUD and 65% of DMPA users were adherent at 48 weeks. Receiving first-choice contraceptive was not associated with adherence. Women commonly cited partner's disapproval as an indication for discontinuation. Women who experienced heavy menstruation and first-time contraceptive users were more likely to be nonadherent. Among ongoing users at study conclusion, 95% were happy with their method, and 98% would recommend their method to a friend. CONCLUSION:Contraceptive adherence between the Cu-IUD and DMPA was similar at 1 year. With similar adherence and similar high rates of satisfaction among users of both methods at 1 year, the Cu-IUD offers a hormone-free alternative to DMPA. IMPLICATIONS: Adherence to the Cu-IUD and DMPA is similar at 1 year among HIV-infected women on HAART in a randomized controlled trial. Despite high method satisfaction, partner disapproval and heavy bleeding contribute to reduced adherence. Receiving a method that differs from participant's first-choice method did not influence adherence.
RCT Entities:
OBJECTIVE: To evaluate contraceptive adherence to the copper intrauterine device (Cu-IUD) and the injectable depot medroxyprogesterone acetate (DMPA) among women with HIV in Lilongwe, Malawi. METHODS: We randomized 200 HIV-infectedwomen on highly active antiretroviral therapy (HAART) to either the Cu-IUD or DMPA and followed these women prospectively, evaluating adherence and factors associated with nonadherence. RESULTS: There was no difference in contraceptive adherence: 68% of Cu-IUD and 65% of DMPA users were adherent at 48 weeks. Receiving first-choice contraceptive was not associated with adherence. Women commonly cited partner's disapproval as an indication for discontinuation. Women who experienced heavy menstruation and first-time contraceptive users were more likely to be nonadherent. Among ongoing users at study conclusion, 95% were happy with their method, and 98% would recommend their method to a friend. CONCLUSION: Contraceptive adherence between the Cu-IUD and DMPA was similar at 1 year. With similar adherence and similar high rates of satisfaction among users of both methods at 1 year, the Cu-IUD offers a hormone-free alternative to DMPA. IMPLICATIONS: Adherence to the Cu-IUD and DMPA is similar at 1 year among HIV-infectedwomen on HAART in a randomized controlled trial. Despite high method satisfaction, partner disapproval and heavy bleeding contribute to reduced adherence. Receiving a method that differs from participant's first-choice method did not influence adherence.
Authors: Charles S Morrison; Stephanie Skoler-Karpoff; Cynthia Kwok; Pai-Lien Chen; Janneke van de Wijgert; Marlena Gehret-Plagianos; Smruti Patel; Khatija Ahmed; Gita Ramjee; Barbara Friedland; Pekka Lahteenmaki Journal: AIDS Date: 2012-02-20 Impact factor: 4.177
Authors: Renee Heffron; Deborah Donnell; Helen Rees; Connie Celum; Nelly Mugo; Edwin Were; Guy de Bruyn; Edith Nakku-Joloba; Kenneth Ngure; James Kiarie; Robert W Coombs; Jared M Baeten Journal: Lancet Infect Dis Date: 2011-10-03 Impact factor: 25.071
Authors: Catherine S Todd; Tracy C Anderman; Sarah Long; Landon Myer; Linda-Gail Bekker; Gregory A Petro; Heidi E Jones Journal: Contraception Date: 2018-02-09 Impact factor: 3.375
Authors: Margaret R Caplan; Raphael J Landovitz; Thesla Palanee-Phillips; Gonasagrie Nair; Felix Mhlanga; Jennifer E Balkus; Sharon A Riddler; Pamina M Gorbach Journal: AIDS Care Date: 2019-02-13
Authors: Lisa B Haddad; Caryl Feldacker; Denise J Jamieson; Hannock Tweya; Carrie Cwiak; Amy G Bryant; Mina C Hosseinipour; Thomas Chaweza; Linly Mlundira; Fanny Kachale; Gretchen S Stuart; Irving Hoffman; Sam Phiri Journal: Int J Gynaecol Obstet Date: 2014-05-13 Impact factor: 3.561
Authors: Lisa B Haddad; Caryl Feldacker; Denise J Jamieson; Hannock Tweya; Carrie Cwiak; Thomas Chaweza; Linly Mlundira; Jane Chiwoko; Bernadette Samala; Fanny Kachale; Amy G Bryant; Mina C Hosseinipour; Gretchen S Stuart; Irving Hoffman; Sam Phiri Journal: PLoS One Date: 2015-03-26 Impact factor: 3.240
Authors: Sam Phiri; Caryl Feldacker; Thomas Chaweza; Linly Mlundira; Hannock Tweya; Colin Speight; Bernadette Samala; Fannie Kachale; Denise Umpierrez; Lisa Haddad Journal: J Fam Plann Reprod Health Care Date: 2015-04-22
Authors: Felix Bongomin; Mercy Chelangat; Anthony Eriatu; Bruno Chan Onen; Priscilla Cheputyo; Stephen A Godmercy; Eddymond Ekuk; Francis Idony; James Henry Obol Journal: Biomed Res Int Date: 2018-06-10 Impact factor: 3.411