BACKGROUND: Hormonal contraception use is common among human immunodeficiency virus (HIV)-infected women. Risk of psychiatric and other noninfectious complications of hormonal contraception use has not been described in this population. METHODS: We performed a retrospective cohort study of HIV-infected women receiving care in Tennessee from 1998 to 2008 to examine the risks of incident psychiatric and other noncommunicable diseases (NCDs), including cardiovascular, hepatic, renal, and malignant diseases, and hormonal contraception use, including depot medroxyprogesterone acetate (DMPA) and combined estrogen- and progestin-containing hormonal contraceptives. We used marginal structural models with inverse probability weights to account for time-varying confounders associated with hormonal contraception use. RESULTS: Of the 392 women included, 94 (24%) used hormonal contraception during the study period. Baseline psychiatric disease was similar between women who received and did not receive hormonal contraception. There were 69 incident psychiatric diagnoses and 72 NCDs. Only time-varying DMPA use was associated with increased risk of psychiatric disease (adjusted odds ratio [aOR] 3.70; 95% confidence interval [95% CI] 1.32-10.4) and mood disorders, specifically (aOR 4.70 [1.87-11.8]). Time-varying and cumulative combined hormonal contraception use were not statistically associated with other NCDs (aOR 1.64, 95% CI 0.64-4.12 and aOR 1.16, 95% CI 0.86-1.56, respectively). However, risk of incident NCDs was increased with cumulative DMPA exposure (per year exposure aOR 1.45, 95% CI 1.01-2.08). CONCLUSIONS: Among HIV-infected women, DMPA was associated with risk of incident psychiatric diseases, particularly mood disorders, during periods of use. Cumulative DMPA exposure was also associated with risk of other NCDs. However, combined estrogen and progestin-containing hormonal contraception use was not statistically associated with risk of any NCDs.
BACKGROUND: Hormonal contraception use is common among human immunodeficiency virus (HIV)-infectedwomen. Risk of psychiatric and other noninfectious complications of hormonal contraception use has not been described in this population. METHODS: We performed a retrospective cohort study of HIV-infectedwomen receiving care in Tennessee from 1998 to 2008 to examine the risks of incident psychiatric and other noncommunicable diseases (NCDs), including cardiovascular, hepatic, renal, and malignant diseases, and hormonal contraception use, including depot medroxyprogesterone acetate (DMPA) and combined estrogen- and progestin-containing hormonal contraceptives. We used marginal structural models with inverse probability weights to account for time-varying confounders associated with hormonal contraception use. RESULTS: Of the 392 women included, 94 (24%) used hormonal contraception during the study period. Baseline psychiatric disease was similar between women who received and did not receive hormonal contraception. There were 69 incident psychiatric diagnoses and 72 NCDs. Only time-varying DMPA use was associated with increased risk of psychiatric disease (adjusted odds ratio [aOR] 3.70; 95% confidence interval [95% CI] 1.32-10.4) and mood disorders, specifically (aOR 4.70 [1.87-11.8]). Time-varying and cumulative combined hormonal contraception use were not statistically associated with other NCDs (aOR 1.64, 95% CI 0.64-4.12 and aOR 1.16, 95% CI 0.86-1.56, respectively). However, risk of incident NCDs was increased with cumulative DMPA exposure (per year exposure aOR 1.45, 95% CI 1.01-2.08). CONCLUSIONS: Among HIV-infectedwomen, DMPA was associated with risk of incident psychiatric diseases, particularly mood disorders, during periods of use. Cumulative DMPA exposure was also associated with risk of other NCDs. However, combined estrogen and progestin-containing hormonal contraception use was not statistically associated with risk of any NCDs.
Authors: Charles S Morrison; Barbra A Richardson; Francis Mmiro; Tsungai Chipato; David D Celentano; Joanne Luoto; Roy Mugerwa; Nancy Padian; Sungwal Rugpao; Joelle M Brown; Peter Cornelisse; Robert A Salata Journal: AIDS Date: 2007-01-02 Impact factor: 4.177
Authors: Matthew S Freiberg; Chung-Chou H Chang; Melissa Skanderson; Kathleen McGinnis; Lewis H Kuller; Kevin L Kraemer; David Rimland; Matthew B Goetz; Adeel A Butt; Maria C Rodriguez Barradas; Cynthia Gibert; David Leaf; Sheldon T Brown; Jeffrey Samet; Lewis Kazis; Kendall Bryant; Amy C Justice Journal: Circ Cardiovasc Qual Outcomes Date: 2011-06-28
Authors: Helen E Cejtin; Lisa Jacobson; Gayle Springer; D Heather Watts; Alexandra Levine; Ruth Greenblatt; Kathryn Anastos; Howard L Minkoff; Leslie S Massad; Julie B Schmidt Journal: AIDS Date: 2003-07-25 Impact factor: 4.177
Authors: Kinda Aljassem; Janet M Raboud; Trevor A Hart; Anita Benoit; DeSheng Su; Shari L Margolese; Sean B Rourke; Sergio Rueda; Ann Burchell; John Cairney; Paul Shuper; Mona R Loutfy Journal: J Int Assoc Provid AIDS Care Date: 2014-06-04