Johns Hopkins Bloomberg School of Public Health: The INFO Project

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Dr. Jim Shelton's Pearls "Pearl" for the week of November 28, 2003

IUDs for HIV+ Women

It seems to me that many women who are infected with HIV might want a very effective method of contraception. Are IUDs recommended for women who are infected with HIV?

In general, yes. In a notable shift, at its most recent expert meeting, WHO has revised its position and now classifies HIV infection (which has not yet progressed to actual AIDS) as a Category 2 - (Generally use the method.)

This position was in part based on an FHI-supported prospective study in Kenya which found that HIV+ and HIV- women adopting IUDs had similar rates of complications. This finding held when analyzed according to varying CD4 count. Likewise IUD use did not appear to increase shedding of the virus in vaginal secretions.

Women whose HIV infection has actually progressed to AIDS, remain classified as Category 3 - (Usually not recommended unless other methods are not available or appropriate.) However for women with AIDS already using the IUD and wanting to continue use or for those women with AIDS who are clinically well on ARV therapy, IUD use is also Category 2.

References:

1. Morrison CS et al. Is the intrauterine device appropriate contraception for HIV-1 infected women? BJOG. 2001 Aug;108(8):784-90.

The "Pearls" offer answers to commonly asked questions about family planning. These "Pearls" are prepared by Dr. James D. Shelton, Senior Medical Scientist, Office of Population, United States Agency for International Development (USAID)

Disclaimer: The information provided on this web site is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development, the U.S. Government or The Johns Hopkins University.