Hormonal contraceptive use, herpes simplex virus infection, and risk of HIV-1 acquisition among Kenyan women

Baeten, Jared M.; Benki, Sarah; Chohan, Vrasha; Lavreys, Ludo; McClelland, R. Scott; Mandaliya, Kishorchandra; Ndinya‐Achola, Jeckoniah; Jaoko, Walter; Overbaugh, Julie

doi:10.1097/qad.0b013e328270388a

Cited by 150 publications

(149 citation statements)

References 33 publications

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“…Our finding is however in agreement with another study report from Kenya [35]. Misguided confidence in the protective role of hormonal contraceptives may explain the significantly increased prevalence of HSV-2 among hormonal contraceptive users in this study.…”

Section: Discussionsupporting

confidence: 38%

Sexual behavioral correlates with HSV-2 seroprevalence among pregnant women in Nigeria

Kalu

Ojide

Fowotade

et al. 2014

J Infect Dev Ctries

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Introduction: The burden of HSV-2 infection, the cause of most cases of genital herpes in Nigeria, varies from region to region; and so are the associated factors. This infection is known to be responsible for several negative pregnancy outcomes. There is currently no documented data on sexual behavioral factors associated with the occurrence of HSV-2 infection or seroprevalence among pregnant women in Nigeria. This study aimed at identifying the sexual behavioral correlates of HSV-2 seroprevalence among pregnant women in Benin City, Nigeria. Methodology: The cross-sectional study design was adopted and the study took place between November 2011 and June 2012. Four hundred and ten consenting ante-natal clinic patients in two major tertiary hospitals in Benin City were consecutively and prospectively included. Data sources were represented by questionnaires, the patient's case records and laboratory investigations. Each patient's serum was analyzed for HSV-2 antibody detection. Data analysis was performed using SPSS version 16. Results: Four hundred and ten patients were enrolled with average age 30.6 years. Seroprevalence of HSV-2 antibody was 47.3%. Sexual behavioral factors that were significantly associated with HSV-2 seroprevalence included early exposure to sexual intercourse, number of sex partners, involvement in polygamous marriages, involvement of husband in extra-marital affairs and hormonal contraceptive use. Conclusion: The prevalence of HSV-2 among pregnant women in Benin City is high. Public health campaigns aimed at: delaying onset of sexual activity; encouraging monogamous relationships; and emphasizing that hormonal contraceptives do not protect from STI's, are recommended.

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Section: Discussionsupporting

confidence: 38%

Sexual behavioral correlates with HSV-2 seroprevalence among pregnant women in Nigeria

Kalu

Ojide

Fowotade

et al. 2014

J Infect Dev Ctries

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“…7 In South Africa, hormonal contraceptives, particularly injectables, are reported to be the most common contraceptive method because they are highly effective and safe. [8][9][10] Contraceptives play a key role in efforts to prevent HIV-1 infection by reducing the number of unintended pregnancies and, hence, the number of potential cases of motherto-child transmission of HIV-1.…”

Section: Introductionmentioning

confidence: 99%

Population-level impact of hormonal contraception on incidence of HIV infection and pregnancy in women in Durban, South Africa

Ramjee¹,

Wand²

2012

Bull World Health Org

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“…In light of multiple studies implicating hormonal contraception use with increased susceptibility to HIV-1 infection [5][6][7][8][9][10][11] , identifying safe and effective contraceptives is a critical public health issue 4 . This study examined alterations to systemic and local immune mediators associated with extended use of hormonal contraception in order to delineate biological mechanisms that may affect the susceptibility to HIV-1 and other sexually transmitted diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Areas with high use of injectables often overlap with areas of high HIV-1 incidence, particularly in eastern and southern Africa 3 . Unfortunately, several studies have suggested that the use of hormonal contraceptives, particularly DMPA, is associated with an increased risk of acquiring and transmitting HIV-1 [4][5][6][7][8][9][10] . A recent observational study among HIV-1 serodiscordant couples indicated that the risk of acquiring HIV-1 was increased 2 to 3.9-fold in women using DMPA compared to non-hormonal contraception users 6,11 .…”

Section: Introductionmentioning

confidence: 99%

Effect of hormonal contraception on the function of plasmacytoid dendritic cells and distribution of immune cell populations in the female reproductive tract

2016

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Objective-Epidemiological evidence suggests an association between the use of hormonal contraception and an increased risk of acquiring sexually transmitted diseases including HIV-1. We sought to elucidate the biological mechanisms underlying the effect of hormonal contraception on the immune system.Design-Cross-sectional study.Methods-To delineate the biological mechanisms underlying the effect of hormonal contraceptives on the immune system, we analyzed the functional capacity of circulating plasmacytoid dendritic cells (pDCs), the distribution of vaginal immune cell populations, and the systemic and genital levels of immune mediators in women using depot medroxyprogesterone acetate (DMPA), NuvaRing, or combined oral contraceptives (COC).Results-The use of DMPA or NuvaRing was associated with reduced capacity of circulating pDCs to produce IFNα and TNFα in response to TLR-9 stimulation. Systemic levels of IFNα and cervicovaginal fluid levels of IFNα, CXCL10, MCP-1, and G-CSF were significantly lower in DMPA users compared to control volunteers not using hormonal contraception. The density of CD207 + Langerhans cells in the vaginal epithelium was reduced in NuvaRing and COC users but not in DMPA users.Conclusions-The presented evidence suggests that the use of some types of hormonal contraception is associated with reduced functional capacity of circulating pDCs and altered immune environment in the female reproductive tract.

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Hormonal contraceptive use, herpes simplex virus infection, and risk of HIV-1 acquisition among Kenyan women

Abstract: In this group of high-risk African women, hormonal contraception and HSV-2 infection were both associated with increased risk for HIV-1 acquisition. HIV-1 risk associated with hormonal contraceptive use was not related to HSV-2 serostatus.

Cited by 150 publications

References 33 publications

Sexual behavioral correlates with HSV-2 seroprevalence among pregnant women in Nigeria

Sexual behavioral correlates with HSV-2 seroprevalence among pregnant women in Nigeria

Population-level impact of hormonal contraception on incidence of HIV infection and pregnancy in women in Durban, South Africa

Effect of hormonal contraception on the function of plasmacytoid dendritic cells and distribution of immune cell populations in the female reproductive tract

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