The Safeness of IUDs for HIV-positive Women
1. Women infected with the most common form of HIV may safely use the intrauterine device (IUD)for contraception, provided they see a doctor regularly, new study findings suggest.
2. World Health Organization guidelines currently state that, in general, HIV-infected women should avoid IUDs. “Those guidelines were essentially made on theoretical concerns, and there are really very little data on what contraceptive is appropriate for HIV-infected women,3” said the lead author Dr. Charles S. Morrison in North Carolina4.
3. Morrison and colleagues gathered information on IUD-related complications at 1, 4 and 24 months after placement of the device in 636 women living in Nairobi, Kenya5. Of these women, 156 had HIV infection. Participating physicians did not know the patients’ HIV status. There was “little difference in any side effects in HIV-infected women compared with HIV-uninfected women, suggesting that the IUD is likely an appropriate method for HIV-infected women,” Morrison said. “This is an important issue, because there are now 16 million women living with HIV and a lot of them have a critical need for contraception,” he added.
4. The researchers did find6 that women with infections such as gonorrhea or chlamydia at the study’s outset were at increased risk of IUD complications, confirming current guidelines suggesting that women with sexually transmitted diseases not use IUDs.7
5. In addition, there was no difference in the amount of virus the HIV-positive women were releasing from their cervix, or shedding8, at the beginning of the study compared with 4 months after the IUD was inserted, the researchers reported in the August issue of the British Journal of Obstetrics and Gynaecology. Conversely, some studies have shown a relationship between increased cervical HIV shedding and the use of oral contraceptives.
6. “What this study suggests is that you need to avoid IUD use in women with a cervical infection but not women with HIV infection,”Morrison said. “Women with cervical infections are at increased risk of complications: women with HIV infection are not.”
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