Title: Human immunodeficiency virus transmission and oral contraceptives [letter]

POPLINE Document Number: 120370

Author(s):

Nicolosi A

Source citation:

JOURNAL OF INFECTIOUS DISEASES, 1993 May;167(5):1256-7.

Abstract:

A recently published study by Plourde et al of 600 women attending a sexually transmitted disease clinic in Nairobi, Kenya, identified oral contraceptives (OCs) as a significant risk factor in human immunodeficiency virus (HIV) infection. The odds ratio of HIV for women using OCs for 12 or more months was 1.9 (95% confidence interval, 1.04-3.6) compared to OC use for under 12 months when adjusted for number of lifetime sexual partners and 1.9 (95% confidence interval, 1.05-3.6) when adjusted for condom use. This analysis is flawed, however, by the inclusion of women with no history of OC use in the < 12 months of OC use group. Also suggestive of methodological bias is the finding of an odds ratio for condom use (adjusted for OC use) of 3.02 (95% confidence interval, 1.6-5.6). The high correlation among OC use, condom use, prostitution, and genital ulcers present in this study creates potential for bias and misclassification. The finding of another case-control study that OC use confers a 60% reduction in HIV risk suggests a need for further research in this area before OCs are designated a risk factor for HIV.

Keywords:

Critique
HIV Infections
Oral Contraceptives
Risk Factors
Bias
Viral Diseases
Diseases
Contraceptive Methods
Contraception
Family Planning
Biology
Error Sources
Measurement
Research Methodology