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Contraceptive implant failures among women using antiretroviral therapy in western Kenya: a retrospective cohort study.
Pfitzer, Anne; Wille, Jacqueline; Wambua, Jonesmus; Stender, Stacie C; Strachan, Molly; Ayuyo, Christine Maricha; Muhavi, Timothy F Kibidi; Wabwile, Valentino; Mehta, Supriya D; Sasser, Elizabeth.
Afiliación
  • Pfitzer A; Maternal and Child Survival Program/Jhpiego, 1776 Massachusetts Ave, NW Suite 300, Washington, DC, 20036, USA.
  • Wille J; Maternal and Child Survival Program/Jhpiego, 1776 Massachusetts Ave, NW Suite 300, Washington, DC, 20036, USA.
  • Wambua J; Jhpiego, Arlington Block, 14 Riverside, Nairobi, Kenya.
  • Stender SC; Jhpiego, Cape Town, South Africa.
  • Strachan M; Maternal and Child Survival Program/Jhpiego, 1776 Massachusetts Ave, NW Suite 300, Washington, DC, 20036, USA.
  • Ayuyo CM; Independent researcher, Nairobi, Kenya.
  • Muhavi TFK; Center for Health Solutions, Kasuku Road, Nairobi, Kenya.
  • Wabwile V; Jhpiego, Arlington Block, 14 Riverside, Nairobi, Kenya.
  • Mehta SD; School of Public Health, University of Illinois at Chicago, 1603 W Taylor Street, Chicago, IL, 60612, USA.
  • Sasser E; Jhpiego, Seattle, WA, USA.
Gates Open Res ; 3: 1482, 2019.
Article en En | MEDLINE | ID: mdl-32051928
Background: Women living with HIV have the right to choose whether, when and how many children to have. Access to antiretroviral therapy (ART) and contraceptives, including implants, continues to increase due to a multitude of efforts. In Kenya, 4.8% of adults are living with HIV, and in 2017, 54% were receiving an efavirenz-based ART regimen. Meanwhile, 16.1% of all Kenyan married (and 10.4% of unmarried) women used implants. Studies have reported drug interactions leading to contraceptive failures among implant users on ART. This retrospective record review aimed to determine unintentional pregnancy rates among women 15-49 years of age, living with HIV and concurrently using implants and ART in western Kenya between 2011 and 2015. Methods: We reviewed charts of women with more than three months of concurrent implant and ART use. Implant failure was defined as implant removal due to pregnancy or birth after implant placement, but prior to scheduled removal date. The incidence of unintended pregnancy was calculated by woman-years at risk, assuming a constant rate. Results: Data from 1,152 charts were abstracted, resulting in 1,190 implant and ART combinations. We identified 115 pregnancies, yielding a pregnancy incidence rate of 6.32 (5.27-7.59), with 9.26 among ETG and 4.74 among LNG implant users, respectively. No pregnancies were recorded among women on non-NNRTI-based regimens, whereas pregnancy rates for efavirenz and nevirapine-containing regimens were similar, at 6.41 (4.70-8.73) and 6.44 (5.13-8.07), respectively. Conclusions: Our findings highlight the implications of drug interaction on women's choices for contraception.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Gates Open Res Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Gates Open Res Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos