High HIV incidence among young women in South Africa: Data from a large prospective study

作者：Thesla Palanee‐Phillips, Helen Rees, Kate B. Heller, Khatija Ahmed, Joanne Batting, Ivana Beesham, Renee Heffron, Jessica Justman, Heeran Makkan, Timothy D. Mastro, Susan Morrison, Nelly Mugo, Gonasagrie Nair, James Kiarie, Neena M. Philip, Melanie Pleaner, Krishnaveni Reddy, Pearl Selepe, Petrus S. Steyn, Caitlin W. Scoville, Jenni Smit, Katherine K. Thomas, Deborah Donnell, Jared M. Baeten · 发表于：PLoS ONE · 年份：2022 · DOI：10.1371/journal.pone.0269317 · 被引用次数：35 · 研究领域：Reproductive tract infections research、HIV/AIDS Research and Interventions、Reproductive Health and Contraception

INTRODUCTION: South Africa has the highest national burden of HIV globally. Understanding drivers of HIV acquisition in recently completed, prospective studies in which HIV was an endpoint may help inform the strategy and investments in national HIV prevention efforts and guide the design of future HIV prevention trials. We assessed HIV incidence and correlates of incidence among women enrolled in ECHO (Evidence for Contraceptive Options and HIV Outcomes), a large, open-label randomized clinical trial that compared three highly effective. reversible methods of contraception and rates of HIV acquisition. METHODS: During December 2015 to October 2018, ECHO followed sexually active, HIV-seronegative women, aged 16-35 years, seeking contraceptive services and willing to be randomized to one of three contraceptive methods (intramuscular depot medroxyprogesterone acetate, copper intrauterine device, or levonorgestrel implant) for 12-18 months at nine sites in South Africa. HIV incidence based on prospectively observed HIV seroconversion events. Cox proportional hazards regression models were used to define baseline cofactors related to incident HIV infection. RESULTS: 5768 women were enrolled and contributed 7647 woman-years of follow-up. The median age was 23 years and 62.5% were ≤24 years. A total of 345 incident HIV infections occurred, an incidence of 4.51 per 100 woman-years (95%CI 4.05-5.01). Incidence was >3 per 100 woman-years at all sites. Age ≤24 years, baseline infection...