Norethisterone Enanthate

Background. Family planning (FP) is one of the fundamental pillars of safe motherhood and reproductive health rights. In developing countries, women with unmet need for FP constitute a significant proportion of all women of reproductive age and it is an ongoing public health challenge in the Gambia. The study aimed to determine the women’s proportion of contraceptive uptake and knowledge of FP methods. Methods. The study employed a community-based descriptive cross-sectional study conducted for 643 women of reproductive age (15–49 years) from the selected clusters in rural Gambia through a multistage sampling technique. A pretested structured interview questionnaire was used to collect data. Univariate analysis using frequencies and percentages were used to present results in this study. Data entry and analysis were done using IBM SPSS version 24. Results. The overall contraceptive prevalence rate was 30.4%, while the CPR for married or in the union was 34.2%. About 86% of women reported child spacing as the major benefits of FP, while 49.5% reported amenorrhea as the most common side effect of contraceptives. Injectable (Depo-Provera, Noristerat, and ) and pills (progesterone and combined) were the two most common FP methods used at 58.5% and 44.0%, respectively. Conclusion. The present study showed a moderately low contraceptive uptake. Thus, there is a need to focus FP services for women in rural areas, emphasizing the quality of services and gender equality. The study further recommends strengthening and mainstreaming of male involvement and religious leaders participation in FP interventions and the initiation of a communication program that explicitly promotes interspousal communication.

Contraceptive hormones are systemically active, potent, and likely to invoke biological responses other than known fertility regulation impacts. We hypothesized that initiation of depot medroxyprogesterone acetate (DMPA) would increase genital HIV‐target‐cells and soluble immune mediators compared with baseline and initiation of other contraceptive methods.

We collected cervical cytobrushes and cervicovaginal fluid from healthy Zimbabwean women aged 18‐34 to assess immune cell populations, cytokines, and innate anti‐HIV activity at baseline and after 30, 90, and 180 days use of DMPA (n = 38), norethisterone enanthate (n = 41), medroxyprogesterone acetate/estradiol cypionate (n = 36), levonorgestrel implant (n = 43), etonogestrel implant (n = 47), or copper intrauterine device (Cu‐IUD) (n = 45). Cells were quantified by flow cytometry, cytokines were detected by multiplex assays, and innate anti‐HIV activity was assessed by in vitro HIV challenge.

Compared to baseline, the number of cervical HIV target cells (#CD4 cells P < .04 and #CD11c cells P < .04), the concentration of the inflammatory cytokine IL‐1β (P < .01), and the innate in vitro anti‐HIV activity (P < .001) significantly decreased following DMPA initiation. In Cu‐IUD users, genital HIV target cells increased (#CD4 cells P < .001, #CD4CCR5 cells P = .02, #CD4CD69 cells P < .001, #CD8CD69 P = .01, and #CD11c cells P = .003) at day 30 and resolved by day 180. IFN‐γ (P < .001), IL‐1β (P < .001), IL‐6 (P < .001), IL‐8 (P < .001), IL‐10 (P < .01), and RANTES (P < .001) were also significantly increased at day 30. Minimal alterations were observed following initiation of subdermal implantable contraceptives.

This head‐to‐head study compared six contraceptives and found increased HIV target cells and cervical inflammation temporally associated with Cu‐IUD initiation. Use of hormonal contraception, including DMPA, did not increase cervical HIV target cells or inflammation.Clinical Trial Number: NCT02038335