Imperial College London
Alternate

DrJenniferSmith

Faculty of Medicine, School of Public Health

Honorary Research Fellow
 
 
 
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Contact

 

+44 (0)20 7594 3288jennifer.smith

 
 
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Location

 

Middle BayNorfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Butler:2013:10.1097/QAD.0b013e32835a5a52,
author = {Butler, AR and Smith, JA and Polis, CB and Gregson, S and Stanton, D and Hallett, TB},
doi = {10.1097/QAD.0b013e32835a5a52},
journal = {AIDS},
pages = {105--113},
title = {Modelling the global competing risks of a potential interaction between injectable hormonal contraception and HIV risk},
url = {http://dx.doi.org/10.1097/QAD.0b013e32835a5a52},
volume = {27},
year = {2013}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Some, but not all, observational studies have suggested an increase in the risk of HIV acquisition for women using injectable hormonal contraception (IHC).Methods: We used country-level data to explore the effects of reducing IHC use on the number of HIV infections, the number of live births and the resulting net consequences on AIDS deaths and maternal mortality for each country.Results: High IHC use coincides with high HIV incidence primarily in southern and eastern Africa. If IHC increases the risk of HIV acquisition, this could generate 27000–130000 infections per year globally, 87–88% of which occur in this region. Reducing IHC use could result in fewer HIV infections but also a substantial increase in live births and maternal mortality in countries with high IHC use, high birth rates and high maternal mortality: mainly southern and eastern Africa, South-East Asia, and Central and South America. For most countries, the net impact of reducing IHC use on maternal and AIDS-related deaths is dependent on the magnitude of the assumed IHC–HIV interaction.Conclusions: If IHC use increases HIV acquisition risk, reducing IHC could reduce new HIV infections; however, this must be balanced against other important consequences, including unintended pregnancy, which impacts maternal and infant mortality. Unless the true effect size approaches a relative risk of 2.19, it is unlikely that reductions in IHC could result in public health benefit, with the possible exception of those countries in southern Africa with the largest HIV epidemics.
AU  - Butler,AR
AU  - Smith,JA
AU  - Polis,CB
AU  - Gregson,S
AU  - Stanton,D
AU  - Hallett,TB
DO  - 10.1097/QAD.0b013e32835a5a52
EP  - 113
PY  - 2013///
SN  - 0269-9370
SP  - 105
TI  - Modelling the global competing risks of a potential interaction between injectable hormonal contraception and HIV risk
T2  - AIDS
UR  - http://dx.doi.org/10.1097/QAD.0b013e32835a5a52
UR  - http://hdl.handle.net/10044/1/30681
VL  - 27
ER  -
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