Changes in key vaginal bacteria among postpartum African women initiating intramuscular depot-medroxyprogesterone acetate.

PloS One
Bridget M WhitneyAlison C Roxby

Abstract

The ECHO trial has relieved apprehension about intramuscular depot medroxyprogesterone acetate (DMPA-IM), however it is still important to understand how DMPA-IM affects the vaginal environment. We sought to describe how DMPA-IM initiation influences vaginal bacteria associated with HIV acquisition in postpartum women. Vaginal swabs were collected for Nugent score determination and taxon-specific quantitative PCR of eight bacteria. Enrollment occurred at contraceptive initiation (DMPA-IM or non-hormonal contraception (non-HC)) and repeat vaginal swabs were collected after three months. Generalized estimating equations were used to estimate changes in Nugent score, total bacterial load, and taxa concentrations among contraceptive groups. Women who chose DMPA-IM (n = 33) were more likely to be married (97%vs.67%) and have resumed intercourse since delivery (52%vs.29%) compared to women who chose non-HC (n = 21). After three months, significant decreases in the concentrations of Sneathia species, Mycoplasma hominis, and Parvimonas species Type 1 were seen among non-HC users, however concentrations remained stable among DMPA-IM users; contraceptive method was associated with significantly different changes in M. hominis concentrati...Continue Reading

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Citations

Dec 24, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Bridget M WhitneyAlison C Roxby
Jun 3, 2021·Pharmaceutics·Louise CarsonRobert Karl Malcolm
May 16, 2021·American Journal of Reproductive Immunology : AJRI·Hossaena AyeleAdam Burgener

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Methods Mentioned

BETA
contraception
PCR

Software Mentioned

Stata

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