A collaborative study that included the Institute for Global Health and Infectious Diseases, UNC Project-Malawi, and the UNC Center For AIDS Research (CFAR), compared the contraceptive effectiveness of a typical-use LNG implant and depot medroxyprogesterone acetate (DMPA) injectable during efavirenz use. The study included women living with HIV (WLHIV) on efavirenz-containing antiretroviral treatment in Lilongwe, Malawi. Eligible participants were 18–40 years of age and initiating LNG implant or DMPA injectable with a desire to prevent pregnancy for 4+ years. Katie Mollan, PhD, a member of CFAR, led the project as her dissertation. Jennifer Tang, MD, MSCR, was the principal investigator.
Study visits and urine pregnancy testing occurred at enrollment, week 4, and every 24 weeks up to week 192. The team enrolled 1,179 WLHIV on efavirenz: 592 and 587 chose to initiate the LNG implant and DMPA, respectively.
In many settings, LNG implant was found to offer better contraceptive effectiveness than DMPA injectable. However, for WLHIV on efavirenz, the team observed similar typical-use effectiveness for LNG implant versus provider-administrated DMPA injectable during the initial 1–2 years of use.
Altogether, the research team included Katie Mollan, Brian Wells Pence, Daniel Westreich, Agatha Bula, Clara Lemani, John Chapola, Jill Hagey, Karen Diepstra, Jennifer Winston, Sam Phiri, Jane Chiwoko, Lameck Chinula, Mina Hosseinipour, Michael G. Hudgens, Mackenzie Cottrell, Audrey Pettifor, and Jennifer Tang.