Hormonal contraception and HIV acquisition: reanalysis using marginal structural modeling

• DOI: 10.1097/qad.0b013e32833a2537
• Publication Date: 2010-06-29T07:39:23Z
• Authors: Charles S Morrison; Pai-Lien Chen; Cynthia Kwok; Barbra A Richardson; Tsungai Chipato; Roy Mugerwa; Josaphat Byamugisha; Nancy Padian; David D Celentano; Robert A Salata
• Keywords: Hormonal contraception; Medroxyprogesterone; Marginal structural model

Hormonal contraceptives are used widely worldwide; their effect on HIV acquisition remains unresolved. We reanalyzed data from the Contraception and Study using marginal structural modeling to reduce selection bias due time-dependent confounding. Replicating our original analysis closely, we found that depo-medroxyprogesterone acetate (DMPA) but not combined oral contraceptive (COC) was associated with increased acquisition. Also, young (18-24 years) older women who DMPA COCs were at risk.