{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T22:29:19Z","timestamp":1785882559175,"version":"3.56.0"},"reference-count":19,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T00:00:00Z","timestamp":1596067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T00:00:00Z","timestamp":1596067200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Research and Human Retroviruses"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:p>\n                    Limited data exist on the effects of contraceptives on HIV disease progression. We studied the association between intramuscular injectable depot medroxyprogesterone acetate (DMPA-IM), the copper intrauterine device (IUD), and the levonorgestrel (LNG) implant on markers of HIV disease progression at the time of HIV detection and 3 months postdetection and time from detection to CD4 count &lt;350 cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    . Among women initiating antiretroviral therapy (ART), we studied the effect of contraceptive group on time from ART initiation to viral load (VL) &lt;40 copies\/mL. We included women 16\u201335 years randomized to DMPA-IM, copper IUD, or LNG implant with incident HIV infection during the Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009382). We analyzed HIV VL and CD4 cell count according to participants' randomized method and also conducted a \u201ccontinuous use\u201d analysis that excluded follow-up time after method discontinuation. We used adjusted linear models to compare mean VL and CD4 cell levels by contraceptive group up to the time of ART initiation. We compared time from HIV detection to CD4 count &lt;350 cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    and, following ART initiation, time to viral suppression (VL &lt;40 copies\/mL) using Cox proportional hazards models. At HIV detection, women allocated to DMPA-IM had lower VL relative to copper IUD (\u22120.28 log\n                    <jats:sub>10<\/jats:sub>\n                    copies\/mL; 95% confidence interval [CI]: \u22120.55 to \u22120.01) and LNG implant (\u22120.27, CI: \u22120.55 to 0.02) and higher mean CD4 than copper IUD users by 66 cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    (CI: 11\u2013121). In continuous use analyses women allocated to DMPA-IM progressed to CD4\u2009&lt;\u2009350 cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    slower than copper IUD users (hazard ratio [HR]\u2009=\u20090.6, CI: 0.3\u20131.1), whereas copper IUD users progressed faster than LNG implant users (HR\u2009=\u20091.8, CI: 1.0\u20133.3). Time to viral suppression was faster for DMPA-IM than copper IUD (HR\u2009=\u20091.5, CI: 1.0\u20132.3) and LNG implant 1.4 (CI: 0.9\u20132.2) users. We found no evidence of more rapid early HIV disease progression among women using DMPA-IM than among women using copper IUD or LNG implant. Our finding of more rapid progression among copper IUD compared with DMPA-IM users should be interpreted cautiously.\n                  <\/jats:p>","DOI":"10.1089\/aid.2020.0015","type":"journal-article","created":{"date-parts":[[2020,5,12]],"date-time":"2020-05-12T05:13:20Z","timestamp":1589260400000},"page":"632-640","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of Depot Medroxyprogesterone Acetate, Copper Intrauterine Devices, and Levonorgestrel Implants on Early HIV Disease Progression"],"prefix":"10.1177","volume":"36","author":[{"given":"Charles S.","family":"Morrison","sequence":"first","affiliation":[{"name":"FHI 360, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Justus","family":"Hofmeyr","sequence":"additional","affiliation":[{"name":"Effective Care Research Unit, Department of Obstetrics and Gynaecology, University of Witwatersrand\/Fort Hare\/Walter Sisulu, East London, South Africa."},{"name":"Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine K.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington, Seattle, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Rees","sequence":"additional","affiliation":[{"name":"Wits Reproductive Health and HIV Institute (Wits RHI), University of Witswatersrand, Johannesburg, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neena","family":"Philip","sequence":"additional","affiliation":[{"name":"Mailman School of Public Health, ICAP at Columbia University, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thesla","family":"Palanee-Phillips","sequence":"additional","affiliation":[{"name":"Wits Reproductive Health and HIV Institute (Wits RHI), University of Witswatersrand, Johannesburg, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavita","family":"Nanda","sequence":"additional","affiliation":[{"name":"FHI 360, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonasagrie","family":"Nair","sequence":"additional","affiliation":[{"name":"Emavundleni Research Center, Capetown, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maricianah","family":"Onono","sequence":"additional","affiliation":[{"name":"KEMRI-RCTP Study Center, Kisumu, Kenya."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy D.","family":"Mastro","sequence":"additional","affiliation":[{"name":"FHI 360, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie","family":"Lind","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington, Seattle, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renee","family":"Heffron","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington, Seattle, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinodh","family":"Edward","sequence":"additional","affiliation":[{"name":"The Aurum Institute, Johannesburg, South Africa."},{"name":"Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA."},{"name":"Faculty of Health Sciences, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen","family":"Deese","sequence":"additional","affiliation":[{"name":"FHI 360, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mags","family":"Beksinska","sequence":"additional","affiliation":[{"name":"MatCH Research Unit (MRU), Faculty of Health Sciences, Department of Obstetrics and Gynecology, University of the Witwatersrand, Durban, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Beesham","sequence":"additional","affiliation":[{"name":"MatCH Research Unit (MRU), Faculty of Health Sciences, Department of Obstetrics and Gynecology, University of the Witwatersrand, Durban, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey S.A.","family":"Stringer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared M.","family":"Baeten","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington, Seattle, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khatija","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Setshaba Research Center, Soshanguve, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Kiarie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelly R.","family":"Mugo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Justman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zelda","family":"Nhlabatsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Bukusi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Louw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda-Gail","family":"Bekker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Smit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandisa","family":"Singata-Madliki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Sibiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret Phiri","family":"Kasaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Baron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Donnell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter B","family":"Gichangi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate B","family":"Heller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nomthandazo","family":"Mbandazayo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Pleaner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin W","family":"Scoville","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Shears","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petrus S.","family":"Steyn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia D.","family":"Welch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,7,30]]},"reference":[{"key":"e_1_3_6_2_2","volume-title":"Adding It Up: Costs and Benefits of Contraceptives-Estimates for 2012","author":"Singh S","unstructured":"Singh S, , Darroch J. Adding It Up: Costs and Benefits of Contraceptives-Estimates for 2012. Guttmacher Institute and United Nations Population Fund, New York, 2012."},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000363778.58203.b6"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/aji.12214"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1210\/er.2017-00103"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000363779.65827.e0"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32835bb672"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2015.10.002"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200403050-00017"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.78.13.7279-7283.2004"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31288-7"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc-2016-101607"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2004.009407"},{"key":"e_1_3_6_14_2","unstructured":"World Health Organization. Family Planning. Fact Sheet No 351. 2013."},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/aji.12214"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32835ad473"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2016.06.011"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2014.09.005"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(15)00153-8"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2009.009020"}],"container-title":["AIDS Research and Human Retroviruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/aid.2020.0015","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/aid.2020.0015","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/aid.2020.0015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:15:26Z","timestamp":1777367726000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1089\/aid.2020.0015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,30]]},"references-count":19,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1089\/aid.2020.0015"],"URL":"https:\/\/doi.org\/10.1089\/aid.2020.0015","relation":{},"ISSN":["0889-2229","1931-8405"],"issn-type":[{"value":"0889-2229","type":"print"},{"value":"1931-8405","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,30]]}}}