CONTRACEPTIVE USE AND HIV-INFECTION IN KENYAN FAMILY-PLANNING CLINIC ATTENDERS

This pilot study aimed to determine the feasibility of a larger study of contraception and risk of HIV infection in women. We also measured risk factors for and occurrence of HIV infection in the participants. A cohort of 1537 seronegative women attending a family planning clinic in Nairobi, Kenya was enrolled and followed for up to 12 months per w oman. HIV testing was done quarterly. A nested case-control analysis w as done with seroconverting women (cases) and 3 matched controls per c ase, who had detailed interviews and received physical examinations an d STD tests. The prevalence of HIV at enrolment was 6.1%; seropositive women were excluded from further analysis. The 12-month life-table cu mulative incidence of HIV was 2.1 per 100 women (95% confidence interv al [CI] 1.1-3.2). In the nested case-control analysis (17 cases and 51 controls), the crude odds ratio of HIV infection comparing oral contr aceptive (OC) users with other women was 3.5 (95% CI 0.8-21.5), which persisted after control for single confounders at a time. The putative association between OC use and HIV infection is critical to public he alth policy, yet no study has been conducted specifically to measure i t, yielding weak and conflicting evidence. We intend to conduct a larg er study with a similar design as the current pilot study, which confi rmed the feasibility of a more definitive project.