Medroxyprogesterone acetate concentrations among HIV-infected depot-medroxyprogesterone acetate users receiving antiretroviral therapy in Lilongwe, Malawi

Abstract

Objective: To compare medroxyprogesterone acetate (MPA) concentrations between HIV-positive women on antiretroviral therapy (ART) and HIV-negative women initiating depot medroxyprogesterone (DMPA) injectable.

Study design: Secondary analysis of 28 HIV-positive women on non-nucleoside reverse transcriptase inhibitor-containing ART regimens and 10 HIV-negative women randomized to initiate DMPA in a clinical trial of progestin contraception in Malawi.

Results: MPA concentrations were significantly lower among HIV-positive women on ART, compared with HIV-negative women, at week 4 and week 13 (p=.03 for both), but not at day 3 or week 26 post-DMPA initiation.

Conclusions: Antiretroviral medications may affect MPA metabolism in HIV-positive African women.

Trial registration: ClinicalTrials.gov NCT02103660.

Keywords: Africa; Antiretroviral therapy; Depot medroxyprogesterone acetate; HIV.

Copyright © 2019 Elsevier Inc. All rights reserved.

Figures

Fig. 1.

Individual MPA Levels (pg/mL) by Visit for HIV-positive Women (n=28) and HIV-negative Women (n=10). *MPA, medroxyprogesterone acetate.

Fig. 2.

MPA Levels (pg/mL) by Visit for Women with MPA