对于艾滋病毒感染风险较高的妇女,使用荷尔蒙避孕药
Christa Rohwer1, Michael McCaul2, G Justus Hofmeyr3,4
1Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
The Cochrane database of systematic reviews
|June 6, 2025
概括
注射性激素避孕药,如DMPA,与IUD相比,在艾滋病毒感染方面差异很小,但可能会增加与LNG植入物相比的风险. 有效的避孕对艾滋病毒发病率高的妇女至关重要.
科学领域:
- 生殖健康 生殖健康
- 传染病流行病学 传染病流行病学
- 避孕技术 避孕技术的使用
背景情况:
- 关于荷尔蒙避孕药,特别是储存的美德酸 (DMPA),以及艾滋病毒感染风险存在争议.
- 由于新的大型随机对照试验 (RCT) 数据,以前的审查需要更新.
研究的目的:
- 评估激素避孕药对艾滋病毒在高艾滋病毒发病率地区居住的妇女感染艾滋病毒的影响.
- 为了比较不同避孕方法的HIV感染率.
主要方法:
- 对RCT进行系统审查和元分析,比较荷尔蒙避孕与非荷尔蒙或替代避孕方法.
- 搜索了多个数据库 (CENTRAL,MEDLINE,Embase,SCOPUS,Global Index Medicus) 和临床试验登记册,截至2023年9月13日.
- 使用柯克兰偏差风险2工具评估偏差风险,使用GRADE评估证据确定性.
主要成果:
- DMPA注射与铜IUD对艾滋病毒感染的差异很小 (中度确定性证据),但减少了怀孕和停止治疗.
- 莱沃诺格斯特雷尔 (LNG) 植入物与铜IUD对艾滋病毒感染的差异很小 (中度确定性证据) 和略有减少怀孕.
- DMPA注射与液化天然气植入物相比,可能会略微增加艾滋病毒感染 (中等确定性证据),但减少不良事件和停止治疗.
结论:
- 在高患病率环境中的避孕群体中,艾滋病毒发病率仍然很高.
- 虽然DMPA和LNG植入物提供避孕益处,但它们对艾滋病毒感染的影响有所不同,DMPA与LNG植入物相比可能会增加风险.
- 除了有效的避孕措施外,继续强调全面的艾滋病毒预防策略,包括暴露前预防和教育至关重要.
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