Background
Family planning services are vital for women living with HIV (WLH); however, the use of concomitant antiretroviral therapy (ART) and hormonal contraceptives (HCs) may pose challenges due to the risk of potential drug–drug interactions (DDIs). The objectives of this study were to assess ART and HC use among WLH and quantify the frequency of potential DDIs between ART and HCs.
Methods
This was a retrospective, observational, cohort study of WLH aged 18–55 years, prescribed ART, with at least one clinic visit from January 1, 2010 to April 30, 2014. Potential DDIs between HCs and ART were assessed using the University of Liverpool HIV Drug Interactions website (
www.hiv-druginteractions.org
) and categorized as ‘weak potential interaction,’ ‘potential interaction,’ or ‘do not co-administer.’
Results
Overall, a contraceptive method was reported in 167 (54%) of the 309 women included in the study. Of those using contraception, 73 (43.7%) reported using HCs, which was most frequently a progestin intrauterine device (
n
=43), progestin injection (
n
=17), or combination oral contraceptive pills (
n
=9). Out of a total of 449 ART regimens, a potential DDI was identified in 21 of 115 (18.3%) ART–HC combinations from 19 women using ART and HCs. Atazanavir/ritonavir was the most common potentially interacting ART (10, 47.6%); for HCs, these were combination oral contraceptive pills (16, 76.2%) and progestin implants (2, 9.5%).
Conclusion
In this cohort, one-quarter of WLH on ART–HCs had a potential DDI. Future studies should investigate the impact of DDIs on unintended pregnancies, the side effects of DDIs, and the effects of HC DDIs on ART concentrations.
✦ information society ✦ innovation ✦ knowledge society ✦ real-world experiments The terms 'knowledge-' or 'information society' characterize the fundamental structural transformation of societies. The approach to solving socially relevant environmental problems under uncontrolled conditions has become a new challenge for sociologists. Human interventions in these processes have helped to develop theories of real-world experiments in order to improve these interventions. The sociologists Matthias Groß from the Environmental Research Centre in Leipzig, Holger Hoffmann-Riem at the Swiss Transdisciplinarity Net and the sociologist of science Wolfgang Krohn from the University of Bielefeld have written a book that tries to identify new ecological organization processes in the knowledge society.The book has a logical structure. The authors developed four cases for their analysis: first, the strategies of Mkwaja Ranch in Tanzania, where raising cattle in a tsetseinfested savannah reflects both economic and ecological challenges; second, the design of the Green City, a number of parks and beaches along Lake Michigan in Chicago; third, the remediation of Lake Sempachersee in Switezerland; and finally, the authors examine the experimental practices of the German implementation of a largescale waste disposal site.The two cases of Mkawja Ranch and the park design in Chicago are a descriptive and highly argumentative section of this book. The goal of the experiment in Africa was to intervene in the ecological system in order to maximize economic benefits, while in Chicago human intervention was developed to restore the natural environment that was damaged through such interventions. The African 613
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