Depo Provera and Beyond

The Depo Provera and Beyond study is a collaboration between multiple research institutes in the United States, South Africa and Australia, and clinical sites in South Africa, the Dominican Republic and Brazil.

Objective

The aims of this study are to investigate the effects of different long-acting contraceptives on the female genital tract including:

microbiome
inflammatory profile
epithelial barrier integrity
HIV target cell recruitment and activation.

Another aim is to investigate interactions between contraceptives and the microbiome and inflammation that impact HIV acquisition risk.

This study includes clinical specimens and metadata that were collected in three randomised control trials:

Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial
Sayana Press Extension trial
Lower Dose DMPA PK/PD study.

Timeline

2018–ongoing.

Approach

The ECHO clinical trial aimed to evaluate HIV incidence among women randomised to receive 3-monthly intramuscular doses of 150 mg of depot medroxyprogesterone acetate (DMPA), the copper intrauterine device or the levonorgestrel implant in South Africa, Kenya, Zambia and Swaziland.

The Depo Provera and Beyond sub-study is analysing samples collected from 168 South African participants at baseline, and month 1 and month 3 following contraceptive initiation. We additionally aim to analyse samples collected at baseline from 177 women who subsequently acquired HIV and 708 controls who remained HIV-uninfected during the trial.

Sayana Press Extension is a randomised trial to evaluate the contraceptive efficacy of Sayana Press (104 mg DMPA) injected every 4 months among women in the Dominican Republic, Chile and Brazil. Our sub-study is analysing samples collected from 23 participants in Brazil.

Lower Dose DMPA PK/PD Study aimed to evaluate suppression of ovulation of MPA after a single subcutaneous injection of DMPA-SQ 105 mg, 104 mg, 75 mg or 45 mg in the Dominican Republic, Chile and Brazil. Our sub-study is analysing samples collected from 40 participants in Brazil and the Dominican Republic.

Featured publications

08 Apr 2022

Genital inflammatory status and the innate immune response to contraceptive initiation

American Journal of Reproductive Immunology

Lindi Masson

10 Nov 2023

Prevalence and incidence of sexually transmitted infections among South African women initiating injectable and long-acting contraceptives

PLoS ONE

Jennifer Deese

Other research

Effect of contraceptive methods on the vaginal microbiome and host immune factors
Effect of contraceptive methods on the vaginal microbiome and host immune factors

Partners

Funding partner: Depo and Beyond study

National Institutes of Health (NIH)

Funding partners: ECHO clinical trial

Gates Foundation

US Agency for International Development and the President’s Emergency Plan for AIDS Relief

Swedish International Development Cooperation Agency

South African Medical Research Council

UN Population Fund

Funding partner: Sayana Press Extension and Lower Dose DMPA clinical trials

FHI 360

Collaborators

FHI 360

University of Cape Town

Virginia Commonwealth University

Oregon Health and Science University

Match Research Unit

Setshaba Research Centre

Wits Reproductive Health and HIV Institute

Effective Care Research Unit

Qhakaza Mbokodo Research Clinic

Profamilia

University of Campinas

Project contacts

Health themes

Projects

Published research

Careers

Study at Burnet

About us

Where we work

Depo Provera and Beyond

Objective

Timeline

Approach

Featured publications

Genital inflammatory status and the innate immune response to contraceptive initiation

Prevalence and incidence of sexually transmitted infections among South African women initiating injectable and long-acting contraceptives

Other research

Effect of contraceptive methods on the vaginal microbiome and host immune factors

Partners

Funding partner: Depo and Beyond study

Funding partners: ECHO clinical trial

Funding partner: Sayana Press Extension and Lower Dose DMPA clinical trials

Collaborators

Project contacts

Dr Lindi Masson

Co-Primary Investigator

Project team

Dr Lindi Masson

Co-Principal Investigator

Jenna Wilson

Research Assistant

Kavita Nanda

Co-Principal Investigator

FHI 360

Jennifer Deese

Co-Principal Investigator

Pfizer

Gregory Buck

Co-Principal Investigator

Virginia Commonwealth University

Myrna Serrano

Co-Principal Investigator

https://medschool.vcu.edu/about/portfolio/details/mgserrano/

Pai-Lien Chen

Lead Biostatistician

FHI 360

Jerome Strauss

Co-Investigator

University of Pennsylvania

Jennifer Smit

Clinical Site Principal Investigator

MatCH Research Unit

Khatija Ahmed

Clinical Site Principal Investigator

Setshaba Research Center

Mags Beksinska

Clinical Site Principal Investigator

MatCH Research Unit

David Edwards

Bioinformatician

Virginia Commonwealth University

Jonathan Blackburn

Co-Investigator

University of Cape Town

Rushil Harryparsad

PhD student

University of Cape Town

Bahiah Meyer

PhD student

University of Cape Town

Andrea Abrahams

PhD student

University of Cape Town

Monalisa Manhanzva

Postdoctoral Fellow

University of Cape Town

Tariq Ganief

Researcher

University of Cape Town

Linda-Gail Bekker

Clinical Site Principal Investigator

Desmond Tutu Health Foundation