{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T18:43:36Z","timestamp":1773254616887,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HD088279"],"award-info":[{"award-number":["R01HD088279"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dolutegravir (DTG)\u2010based antiretroviral treatment (ART) is broadly prescribed to treat HIV. Effective family planning methods are important for the health of women with HIV (WWH) and their families. For WWH on DTG\u2010based ART, we compared the typical\u2010use effectiveness of levonorgestrel (LNG) implant and Depot\u2010Medroxyprogesterone\u2010Acetate (DMPA) injectable, two commonly used contraceptive methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed a prospective cohort study conducted in Lilongwe, Malawi from 2017 to 2021. Eligible participants were WWH ages 18\u201340\u2009years who desired not to get pregnant for \u2265\u20094\u2009years and chose to initiate either LNG implant or provider\u2010administered DMPA injectable\u00a00\u201328\u2009days before study enrollment. Incident pregnancies were measured by urine pregnancy testing and pregnancy diagnoses at study visits every 24\u2009weeks. The parametric g\u2010formula was applied to estimate the contraceptive effectiveness of LNG implant compared to provider\u2010administered DMPA injectable, assuming the entire study cohort had used DTG\u2010based ART throughout. Contraceptive effectiveness was measured during typical, continued use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 1359 eligible participants were enrolled. At enrollment, the median age was 30 (IQR: 26, 34), and 63% were breastfeeding. With DTG\u2010based ART, the estimated 96\u2010week pregnancy risk was 0.5% with LNG implant and 8.9% with DMPA injectable. The estimated 192\u2010week pregnancy risk was 2.6% with LNG implant and 16.1% with DMPA injectable (risk difference: \u221213.5 percentage points, 95% CI: \u221220.1%, \u22127.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For WWH on DTG\u2010based ART who are seeking reversible contraception, the LNG implant is an effective contraceptive and has\u00a0substantially higher effectiveness than provider\u2010administered DMPA injectables.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70297","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T09:25:51Z","timestamp":1768814751000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Effectiveness of Levonorgestrel Implant and Depot Medroxyprogesterone Acetate Injectable for Women Living With\n                    <scp>HIV<\/scp>\n                    on Dolutegravir\u2010Based Antiretroviral Therapy"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8592-5154","authenticated-orcid":false,"given":"Katie R.","family":"Mollan","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"School of Medicine University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian W.","family":"Pence","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Westreich","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agatha","family":"Bula","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Lemani","sequence":"additional","affiliation":[{"name":"UNC Project\u2010Malawi  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Chapola","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"UNC Project\u2010Malawi  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam","family":"Phiri","sequence":"additional","affiliation":[{"name":"The Lighthouse Trust  Lilongwe Malawi"},{"name":"Partners in Hope  Lilongwe Malawi"},{"name":"School of Global and Public Health Kamuzu University of Health Sciences  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Chiwoko","sequence":"additional","affiliation":[{"name":"The Lighthouse Trust  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael G.","family":"Hudgens","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Gillings School of Global Public Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lameck","family":"Chinula","sequence":"additional","affiliation":[{"name":"School of Medicine University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"UNC Project\u2010Malawi  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina C.","family":"Hosseinipour","sequence":"additional","affiliation":[{"name":"School of Medicine University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"UNC Project\u2010Malawi  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Diepstra","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Winston","sequence":"additional","affiliation":[{"name":"School of Medicine University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill M.","family":"Hagey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Duke University  Durham North Carolina 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Carolina at Chapel Hill  Chapel Hill North Carolina USA"},{"name":"UNC Project\u2010Malawi  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_2_14_2_1","unstructured":"\u201cMalawi Population\u2010Based HIV Impact Assessment (MPHIA 2020\u20132021) \u201d2022."},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.22246"},{"key":"e_1_2_14_4_1","volume-title":"WHO Recommends Dolutegravir as Preferred HIV Treatment Option in All Populations","author":"Lindmeier C.","year":"2019"},{"key":"e_1_2_14_5_1","unstructured":"Government of Malawi Ministry of Health \u201cIntegrated HIV Program Report January\u2010March 2021 \u201d2021."},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2017.03.001"},{"key":"e_1_2_14_7_1","unstructured":"\u201cMalawi Demographic and Health Survey 2015\u20132016 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