Related Experiment Video
Updated: May 7, 2026
12:34
Collection, Isolation, and Flow Cytometric Analysis of Human Endocervical Samples
Published on: July 6, 2014
Hormonal contraception and HIV: the methods have confused the message
Sheree R Schwartz1, Audrey Pettifor, Gretchen S Stuart
1aDivision of Infectious Diseases, Department of Medicine bDepartment of Epidemiology, Gillings School of Global Public Health cDivision of Women's Primary Healthcare, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
AIDS (London, England)
|October 4, 2013
Summary
Confounding by condom use can distort findings on hormonal contraception and HIV risk. Accurate measurement and adjustment for condom use are crucial for reliable research on women's health.
Area of Science:
- Epidemiology
- Public Health
- Contraception Research
Background:
- Hormonal contraception use has been linked to HIV acquisition risk in women.
- Previous studies show conflicting results, potentially due to confounding factors.
- Condom use is a significant behavioral factor that may confound this relationship.
Purpose of the Study:
- To investigate how confounding by condom use affects conclusions about hormonal contraception's impact on HIV acquisition.
- To evaluate the influence of different adjustment strategies for condom use and misreporting.
Main Methods:
- Conducted scenario analyses to assess the impact of crude adjustment for condom use.
- Examined the effect of condom misreporting on relative risk estimates for HIV acquisition.
- Compared injectable hormonal contraception (IHC) users with nonusers.
Main Results:
- Crude adjustment for condom use leads to biased risk estimates if condom use patterns are inconsistent or differ between contraceptive groups.
- Over-reporting of condom use is plausible and can bias estimates, either under- or overestimating risk depending on differential reporting.
- The impact of misreported condom use is most significant in populations with high condom uptake.
Conclusions:
- Discrepant findings in hormonal contraception-HIV research may stem from inadequate adjustment for condom use confounding.
- Future studies must precisely account for condom use in statistical analyses.
- Quantifying condom use misreporting through methods like comparing reported use to pregnancy or STI rates is recommended.
Related Concept Videos
01:22Birth Control Methods
Vasectomy is a surgical form of male sterilization that involves severing and sealing the vasa deferentia, preventing sperm from mixing with semen during ejaculation. Because a vasectomy does not impact the testes' ability to produce testosterone, hormone levels, libido, and sexual function generally remain unchanged. While vasectomy is highly effective in preventing pregnancy, with a success rate near 99.85%, rare cases of recanalization (spontaneous reconnection) can occur. Although vasectomy...
01:10Retrovirus Life Cycles
Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the retrovirus to...
01:26Sexually Transmitted Infections
Sexually transmitted infections (STIs) are diseases transmitted primarily through unsafe sexual interactions. Bacteria, viruses, or parasites cause them and can result in severe health complications if untreated.ChlamydiaThe bacterium Chlamydia trachomatis is responsible for the disease Chlamydia, the most common STI in the United States. This peculiar pathogen requires human cells to reproduce, residing intracellularly. The initial infection often goes unnoticed because it typically does not...
01:21Intrauterine Drug Delivery Systems
Controlled-release systems for intravaginal and intrauterine drug delivery have been developed primarily for the administration of contraceptive steroid hormones. These delivery routes circumvent first-pass hepatic metabolism, thereby enhancing bioavailability and allowing for reduced systemic dosages compared to oral administration. Such approaches contribute to improved therapeutic efficacy and patient compliance, particularly in long-term contraceptive regimens.Intravaginal Drug Delivery...
01:40Hormonal Regulation
Hormones regulate a significant portion of digestion through activation of the neuroendocrine system. The neuroendocrine system of digestion contains many different hormones all with multiple functions that are both, directly and indirectly, involved in digestion.
01:33Hormonal Regulation
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.