Zahra Bayat Jozani1, Saeed Bayanolhagh1, Tofigh Mobaderi2, Salar Pashangzadeh1, Ahmad Sohrabi2, Reza Adl Tabatabai1, Zohre Rostam Afshar1, Minoo Mohraz4, Minoo Saatian5, Sara Ahsani Nasab and Mahbobeh Haj Abdolbaghi1*
Objective: We conducted the present study to investigate the potential effects of hormonal contraception (HC) on disease progression in women living with HIV (WLWH).
Methods: In a historical cohort study, the demographic, medical, and reproductive profiles of 50 women registered at a referral HIV clinic, receiving hormonal contraceptives, were selected and compared with a matched control group of female patients who had consistent condom use. Disease progression was monitored for nine months, considering the time of CD4 cell count below 200, the time of antiretroviral therapy initiation, HIV-RNA viral load, CD4+ T-cell count, and finally, death.
Results and Discussion: The mean HIV-1-RNA plasma viral loads and mean CD4+ T-cell counts differed significantly in time points among patients using hormonal contraceptives, while no significant changes were observed among condom users. The mean age was 31.34 (21-51) years, and the meantime from diagnosis was four years. In pap smear result, 16% atypical squamous cells of undetermined significance (ASCUS), 9.2% low-grade squamous intraepithelial lesions (LGSIL), and 1.3% high-grade squamous intraepithelial lesions (HGSIL) were found. More regular menstruation cycles were reported during our follow-up among patients using HC (8.7%); we had two unintended pregnancy cases among those patients, only used condoms as contraception. HC discontinuation was associated with adverse effects, lack of partners' support in oral contraceptive pills (OCP) use. Adequate counseling about how to properly take HC decreases rates of discontinuation.
Conclusion: HC has shown no significant effects on disease progression among women using antiretroviral drugs.
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