{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:59:58Z","timestamp":1775149198056,"version":"3.50.1"},"reference-count":34,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T00:00:00Z","timestamp":1578528000000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2019,12,4]]},"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To update a 2016 systematic review on hormonal contraception use and HIV acquisition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We searched Pubmed and Embase between 15 January 2016 and 26 June 2019 for longitudinal studies comparing incident HIV infection among women using a hormonal contraceptive method and either non-users or users of another specific hormonal contraceptive method. We extracted information from newly identified studies, assessed study quality, and updated forest plots and meta-analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In addition to 31 previously included studies, five more were identified; three provided higher quality evidence. A randomised clinical trial (RCT) found no statistically significant differences in HIV risk among users of intramuscular depot medroxyprogesterone acetate (DMPA-IM), levonorgestrel implant (LNG implant) or the copper intrauterine device (Cu-IUD). An observational study found no statistically significant differences in HIV risk among women using DMPA, norethisterone enanthate (NET-EN), implants (type not specified) or Cu-IUD. Updated results from a previously included observational study continued to find a statistically significant increased HIV risk with oral contraceptives and DMPA compared with no contraceptive use, and found no association between LNG implant and HIV risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>High-quality RCT data comparing use of DMPA, LNG implant and Cu-IUD does not support previous concerns from observational studies that DMPA-IM use increases the risk of HIV acquisition. Use of other hormonal contraceptive methods (oral contraceptives, NET-EN and implants) is not associated with an increased risk of HIV acquisition.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2019-200509","type":"journal-article","created":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T13:55:12Z","timestamp":1578578112000},"page":"8-16","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Hormonal contraception and HIV acquisition among women: an updated systematic review"],"prefix":"10.1136","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5892-3786","authenticated-orcid":false,"given":"Kathryn M","family":"Curtis","sequence":"first","affiliation":[{"name":"Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2588-1006","authenticated-orcid":false,"given":"Philip C","family":"Hannaford","sequence":"additional","affiliation":[{"name":"Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Isabel","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsungai","family":"Chipato","sequence":"additional","affiliation":[{"name":"University of Zimbabwe College of Health Sciences, Harare, Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petrus S","family":"Steyn","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James N","family":"Kiarie","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,1,9]]},"reference":[{"key":"2025090511173944000_46.1.8.1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/163.2.233"},{"key":"2025090511173944000_46.1.8.2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001228"},{"key":"2025090511173944000_46.1.8.3","unstructured":"World Health Organization (WHO) . Hormonal contraceptive eligibility for women at high risk of HIV. Geneva, Switzerland: WHO, 2017."},{"key":"2025090511173944000_46.1.8.4","unstructured":"World Health Organization (WHO) . World Health Organization medical eligibility criteria for contraceptive use. 5th edn. Geneva, Switzerland: WHO, 2015."},{"key":"2025090511173944000_46.1.8.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31288-7"},{"key":"2025090511173944000_46.1.8.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"2025090511173944000_46.1.8.7","unstructured":"Covidence Systematic Review Software . 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Risk of HIV-1 acquisition among South African women using a variety of contraceptive methods in a prospective study. 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