IUD use in HIV-positive women.

摘要

The levonorgestrel-releasing intrauterine system (LNG-IUS) is WHO Category 3 (risks outweigh benefits) for HIV-positive patients based on theoretical concerns regarding promotion of sexually transmitted infection (STI)/pelvic inflammatory disease (PID) and increased risk of transmission. We are aware of a prospective study done in Kenya that did not show increased risk of complications between HIV-positive and HIV-negative women getting copper T IUDs, although this study only had a 4-month follow-up and was not powered to detect differences [1]. We have a motivated HIV-positive patient with a good CD4 count who really wants LNG-IUS. She uses condoms regularly with her partner. We are curious what other physicians have done in the past with such patients and want to know whether anyone would not be comfortable inserting the IUD.