Impact of Concurrent Initiation of DMPA Contraception and Tenofovir PrEP on Bone Loss in Young Women

This is a clinical study of bone and renal safety with concurrent use of tenofovir (TDF)-based pre-exposure prophylaxis (PrEP) for HIV prevention and depot medroxyprogesterone acetate (DMPA) use for pregnancy prevention. This five-year study will be conducted in Kampala, Uganda and will enroll a prospective cohort of 400 HIV-uninfected young women initiating DMPA and non-hormonal contraception who will all be offered PrEP. Bone health outcomes in women using DMPA and PrEP concurrently will be compared to women using other PrEP/contraceptive combinations. Primary outcomes include assessing the relationship between concurrent use of PrEP and DMPA on bone health including bone mineral density, rates of bone turnover and subclinical kidney injury (precursors to bone loss), and attainment of peak bone mass.