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Sex Transm Infect 88:313 doi:10.1136/sextrans-2012-050548
  • Clinical round-up

Clinical round-up

  1. Mitesh Desai
  1. Correspondence to Mitesh Desai, Specialty Registrar in GUM, Department of Sexual Health & HIV, St Thomas' Hospital, London SE1 7EH, UK; mdesai.pub{at}gmail.com

Injectable long-acting reversible contraceptive (iLARC) users at higher risk of HIV and Chlamydia trachomatis infections

Intuitively, non-barrier forms of contraception increase the risk of sexually transmitted infections. Studies have attempted to quantify the extent of this risk but their results have not been entirely unidirectional. A group of researchers in Durban, South Africa aimed to prospectively analyse the effect of contraception and risk of HIV and Chlamydia in 2236 HIV-negative women1 who were screened for a microbicidal vaginal gel versus placebo HIV prevention trial.2

All women received risk reduction counselling and access to free condoms. Demographic factors were collected at baseline. Self-reported sexual history and contraception use were collected and HIV testing performed at baseline and 3 monthly intervals. Chlamydia trachomatis nucleic acid amplification testing was performed at week 24 only. The primary outcome for the interventions trial was HIV seroconversion before 52 weeks for which the vaginal gel was not efficacious. For the analysis, contraceptive methods were categorised as: none; injectable long-acting reversible contraception (iLARC, which included sub-dermal implants); oral pills; condoms/others (included all other reversible and non-reversible methods).

During the study follow-up, an increased HIV-1 acquisition risk …