Oral contraception and unprotected sex with occasional partners of women HIV-infected through injection drug use

Abstract

Among HIV-infected women, unprotected sex with the main sexual partner is common practice. Conversely, studies about condom use with sexual partners of unknown HIV sero-status are sparsely reported. We aimed to assess the impact of oral contraception on unsafe sexual behaviours with occasional partners in women HIV-infected through injection drug use. The analysis focused on 90 women, enrolled in the French cohort MANIF 2000 and reported having engaged in sexual relationships with occasional partners during a 48-month period. Visits where women reported unprotected sex with occasional partners in the prior 6 months were compared to visits where they reported protected sex using a logistic model based on Generalised Estimating Equations.

Unprotected sex with occasional partners was independently associated with oral contraception (OR[95%CI] = 3.2[1.4–7.2]), reporting only one occasional partner (OR[95%CI] = 3.1[1.6–6.2]) and antiretroviral treatment receipt. No significant association was found between unprotected sex and CD4 level or plasma viral load.

With the growing population of people living with HIV as a chronic infection, the development and evaluation of HIV-prevention interventions tailored toward women remain a public health priority. Risk reduction counselling and interventions are needed to promote either the use of dual contraception or, alternatively, that of female condom.

Acknowledgments

We thank all members of the MANIF 2000 cohort study group: C. Boirot, A.D. Bouhnik, M.P. Carrieri, J.P. Cassuto, M Chesney, P. Dellamonica, P. Dujardin, H. Gallais, J.A. Gastaut, G. Lepeu, C Marimoutou, D. Mechali, J.P. Moatti, J. Moreau, M. Nègre, Y. Obadia, I. Poizot-Martin, C. Pradier, M. Préau, D. Rey, C. Rouzioux, A. Sobel, B. Spire, F. Trémolières, V. Villes, E. Vincent and D. Vlahov.

The authors thank all Health Care Workers involved in data collection and Cecile Chaussignand for her help in data management.

This research was supported by The French National Agency for Aids Research (ANRS, France), the charity organisation ECS-SIDACTION (France), and the Departmental Council (Bouches-du-Rhône, France).