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November 17, 1993

Oral Contraceptive Use and Infectivity of HIV-Seropositive Women

Author Affiliations

Family Health International Research Triangle Park, NC

JAMA. 1993;270(19):2298. doi:10.1001/jama.1993.03510190052014

To the Editor.  —From a cross-sectional study in Kenya, Clemetson and colleagues1 recently reported an association between oral contraceptive (OC) use, cervical ectopy and pregnancy, and human immunodeficiency virus (HIV) DNA detection in cervical, but not in vaginal, secretions of 97 HIV-seropositive women. They concluded that their data support the hypothesis that these factors increase the infectivity of HIV-seropositive women. Given the need for informed decision making concerning pregnancy and contraception among HIV-infected women, these results could be of considerable importance.Clemetson et al detected HIV DNA in 28 (33%) of 84 cervical samples and 13 (17%) of 77 vaginal samples. The odds ratio was used to assess the strength of the association between HIV DNA and these factors in bivariate and multivariate analyses. From the multivariate analysis, odds ratios from a logistic model regressing HIV DNA in cervical secretions on OC use, pregnancy, cervical ectopy, cervical mucopus, and