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Copper intrauterine device use and HIV acquisition in women: a systematic review
- Source :
- BMJ Sexual & Reproductive Health. 46:17-25
- Publication Year :
- 2020
- Publisher :
- BMJ, 2020.
-
Abstract
- ObjectivesTo review systematically copper intrauterine device (Cu-IUD) use and HIV acquisition in women.MethodsWe searched Pubmed, Embase and the Cochrane Library between database inception and 26 June 2019 for longitudinal studies comparing incident HIV infection among women using an unspecified IUD or Cu-IUD compared with non-hormonal or no contraceptive users, or hormonal contraceptive users. We extracted information from included studies, assessed study quality, and summarised study findings.ResultsFrom 2494 publications identified, seven met our inclusion criteria. One randomised controlled trial (RCT), judged “informative with few limitations”, found no statistically significant differences in HIV risk between users of the Cu-IUD and either intramuscular depot medroxyprogesterone acetate (DMPA-IM) or levonorgestrel implant. One observational study, deemed “informative but with important limitations”, found no statistically significant difference in HIV incidence among IUD users compared with women who had tubal ligation or who were not using any contraception. Another “informative but with important limitations” observational study found no difference in HIV incidence between Cu-IUD users and DMPA or norethisterone enanthate injectable, or implant users. An RCT considered “unlikely to inform the primary question” also found no difference in HIV risk between Cu-IUD and progestogen-only injectable users. Findings from the other three “unlikely to inform the primary question” cohort studies were consistent with the more robust studies suggesting no increased risk of HIV acquisition among Cu-IUD users.ConclusionThe collective evidence, including that from a large high-quality RCT, does not indicate an increased risk of HIV acquisition among users of Cu-IUDs.
- Subjects :
- Funding Agency
medicine.medical_specialty
030219 obstetrics & reproductive medicine
Disclaimer
Human immunodeficiency virus (HIV)
Reproductive medicine
Obstetrics and Gynecology
medicine.disease_cause
Intrauterine device
World health
03 medical and health sciences
0302 clinical medicine
Reproductive Medicine
Family medicine
medicine
Guideline development
030212 general & internal medicine
Hiv acquisition
Psychology
Subjects
Details
- ISSN :
- 25152009 and 25151991
- Volume :
- 46
- Database :
- OpenAIRE
- Journal :
- BMJ Sexual & Reproductive Health
- Accession number :
- edsair.doi...........fbe346ca376efddbe05f3e4453d34c59