Research Triangle Park,
The purpose of this study is to find out whether hormonal birth control increases,
decreases, or does not change the risk of women becoming infected with HIV.
Sexual intercourse between men and women is the main way HIV is transmitted. About 90
percent of HIV infections in women are caused by sexual intercourse. Also, hormonal birth
controls are widely used. This study hopes to find out whether hormonal birth control
changes the risk of women becoming infected with HIV.
Heterosexual intercourse is the primary mode of HIV transmission worldwide and accounts for
about 90% of HIV infections in women. Hormonal contraceptives including COCs and injectables
are among the most widely used contraceptives in the world. Understanding the impact of
hormonal contraception on HIV transmission is a critical unanswered public health question.
Because of the critical nature of this issue to women of reproductive age worldwide, a
methodologically sound study must be undertaken. It must be determined if hormonal
contraceptive use increases the risk of HIV infection and the magnitude of the association,
if it exists.
This study takes place in Thailand, Uganda, and Zimbabwe. HIV-seronegative women continue
using their current birth control method (low dose COC, DMPA injections, or non-hormonal
contraceptive methods [condoms, sterilization, or no modern contraception method]) for the
duration of the study. They are followed every 12 weeks for a minimum of 15 months and a
maximum of 24 months, or until seroconversion. Pelvic exams, including Pap smears, are done,
blood samples are drawn, and vaginal and cervical specimens are tested for any sexually
transmitted diseases (STDs). Women are provided with free treatment for any STDs that are
diagnosed. They complete a questionnaire on sexual behavior and contraceptive history;
counseling on contraceptive use and reducing HIV risk is provided.
Women may be eligible for this study if they:
- Are 16 to 35 years of age.
- Attend family planning and maternal and child health clinics in Zimbabwe, Thailand,
- Have been using low-dose birth control pills, DMPA injections, or non-hormonal birth
control (condoms, sterilization, or no modern birth control method) for at least 3
months and plan to continue using the same type of birth control for a year.
- Are HIV-negative.
- Are sexually active.
- Are at least 4.5 months after delivery, if they have given birth.
- Agree to all study procedures, including HIV testing every 3 months, follow-up clinic
visits, and home visits if they fail to return for follow-up.
- Have a home address where they can be reached for follow-up visits.
Women will not be eligible for this study if they:
- Are pregnant or plan to try to become pregnant in the next year. Women who become
pregnant after enrolling in the trial will not be discontinued.
- Are not currently using low-dose birth control pills or DMPA for birth control but
have used low-dose birth control pills within the last 3 months, or DMPA for birth
control within the previous 6 months.
- Are HIV-indeterminate or HIV-positive.
- Have used an IUD for birth control in the last month.
- Have used non-study types of birth control (such as Norplant, NET-EN, or
progestin-only pills) within the last 3 months.
- Have had a full hysterectomy.
- Have had an abortion or miscarriage within the last month.
- Have had a blood transfusion within the last 3 months.
- Were previously or are currently in an HIV vaccine trial.
- Injected illegal drugs within the last 3 months.