Journal of AIDS & Clinical Research

Objective: We conducted the present study to investigate the potential effects of hormonal contraception (HC) on disease progression in women living with HIV (WLWH).

Methods: In a historical cohort study, the demographic, medical, and reproductive profiles of 50 women registered at a referral HIV clinic, receiving hormonal contraceptives, were selected and compared with a matched control group of female patients who had consistent condom use. Disease progression was monitored for nine months, considering the time of CD4 cell count below 200, the time of antiretroviral therapy initiation, HIV-RNA viral load, CD4+ T-cell count, and finally, death.

Results and Discussion: The mean HIV-1-RNA plasma viral loads and mean CD4+ T-cell counts differed significantly in time points among patients using hormonal contraceptives, while no significant changes were observed among condom users. The mean age was 31.34 (21-51) years, and the meantime from diagnosis was four years. In pap smear result, 16% atypical squamous cells of undetermined significance (ASCUS), 9.2% low-grade squamous intraepithelial lesions (LGSIL), and 1.3% high-grade squamous intraepithelial lesions (HGSIL) were found. More regular menstruation cycles were reported during our follow-up among patients using HC (8.7%); we had two unintended pregnancy cases among those patients, only used condoms as contraception. HC discontinuation was associated with adverse effects, lack of partners' support in oral contraceptive pills (OCP) use. Adequate counseling about how to properly take HC decreases rates of discontinuation.

Conclusion: HC has shown no significant effects on disease progression among women using antiretroviral drugs.

Abstract Background: Human Immunodeficiency Virus (HIV) pandemic is a major public health problem globally. People living with HIV/AIDS (PLWHA) now live longer. But they are confronted with many challenges that affect their health-related QOL. Objective: The study aimed at assessing the Health-related quality of life and associated factors among PLWHA on ART at Mettu Karl Specialized Hospital, southwest Ethiopia, 2019. Methods: A facility-based cross-sectional study was conducted from April to May 2019 among 310 randomly selected participants. An interviewer-administered structured questionnaire was used to collect the data. World Health Organization Quality of Life-HIV Brief Version was used to collect the HRQOL data. A logistic regression model was fitted to identify factors associated with health-related quality. Result: Nearly half (46.1%) of the respondents had poor overall HRQOL with mean ±SD 14.60 ± 2.79. Age (AOR= 1.85, 95% CI (1.08, 3.36)), residence (AOR= 1.86, 95% CI (1.15, 2.99)), functional status at initiation of ART (AOR= 1.73, 95% CI (1.04, 2.88)) treatment regimen (AOR= 2.00, 95% CI (1.24, 3.25)) were independent predictors of overall HRQOL. Duration of knowing status was independent predictor of physical domain (AOR=1.78, 95% CI (1.12, 2.83)). Educational status predicted the psychological domain (AOR=0.51, 95%CI (0.30, 0.87)) and spiritual-related domain (AOR=1.90; 95%CI (1.14, 3.16)). Functional status at the start of ART independently predicted the social support domain (AOR=1.82, 95%CI (1.08, 3.05)). Gender (AOR=2.35, 95%CI (1.44, 3.82)) and WHO clinical stage at the start of ART (AOR=2.79, 95%CI (1.34, 5.80)) were independent predictors of environmental domain. Opportunistic infection was independent predictor of spiritual-related domain (AOR=1.91, 95%CI (1.11, 3.27)). Conclusion: This study showed that the overall HRQOL among the study participants was poor. Age, residents, functional status, and ART regimen were determinants of overall HRQOL. Therefore, health providers should use the determinants in assessing HRQOL of PLWHA to facilitate all rounded management of HIV.