Association between hormonal contraceptive use, HIV vaccine acceptance, and anticipated risk compensation among African-American women

Background: Evidence suggests a link between hormonal contraceptive use and HIV risk. It is unclear how the introduction of an HIV vaccine could impact this association. This study assessed the association between hormonal contraceptive (HC) use, HIV vaccine acceptance, and anticipated risk compensation (increasing sexual risk behaviors following HIV vaccination). Methods: Participants were recruited from a family planning clinic in Atlanta, GA serving low-income patients (N=321). Participants were African-American women aged 18-55, HIV-negative or unsure of HIV status, and had unprotected sex in the past 6 months. Data were collected from audio-computer assisted surveys administered in the clinic waiting room. Multivariate regression analyses were used to assess the association between HC use, HIV vaccine acceptance, and risk compensation associated with two hypothetical HIV vaccines (50% and 90% efficacy). Results: Overall, 26% of participants used no contraception, 10% used condoms only, 45% used HC only, and 19% used condoms and HC. HC use was not associated with HIV vaccine acceptance. Controlling for age and receipt of public assistance, participants who used HC only were significantly less likely to report anticipated risk compensation for a vaccine with 50% efficacy (Beta=-0.16, p=.02). Conclusions: Our findings did not support an increase in sexual risk behavior, or anticipated risk compensation, among HC users following HIV vaccination. On the contrary, women using only HC were significantly less likely to anticipate risk compensation for vaccine with 50% efficacy. As the availability of an HIV vaccine approaches, contraceptive use should be considered when addressing possible vaccine-associated risk compensation.