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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
A randomized trial of the intrauterine contraceptive device vs hormonal contraception in women who are infected with the human immunodeficiency virus
American Journal of Obstetrics and Gynecology, Volume 197, No. 2, Year 2007
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Description
Objective: The purpose of this study was to determine whether the intrauterine contraceptive device (IUD) is effective and safe among women who are infected with the human immunodeficiency virus (HIV). Study Design: We randomly assigned 599 postpartum, HIV-infected women in Zambia to receive either a copper IUD or hormonal contraception and followed them for at least 2 years. Results: Women who were assigned randomly to hormonal contraception were more likely to become pregnant than those who were assigned randomly to receive an IUD (rate, 4.6/100 vs 2.0/100 woman-years; hazards ratio, 2.4; 95% CI, 1.3-4.7). One woman who was assigned to the IUD experienced pelvic inflammatory disease (crude rate, 0.16/100 woman-years; 95% CI, 0.004-868); there was no pelvic inflammatory disease among those women who were assigned to hormonal contraception. Clinical disease progression (death or CD4+ lymphocyte count dropping below 200 cells/μL) was more common in women who were allocated to hormonal contraception (13.2/100 woman-years) than in women who were allocated to the IUD (8.6/100 woman-years; hazard ratio, 1.5; 95% CI, 1.04-2.1). Conclusion: The IUD is effective and safe in HIV-infected women. The unexpected observation that hormonal contraception was associated with more rapid HIV disease progression requires urgent further study. © 2007 Mosby, Inc. All rights reserved.
Authors & Co-Authors
Stringer, Elizabeth Mc Phillips
Zambia, Lusaka
Centre for Infectious Disease Research in Zambia
United States, Birmingham
The University of Alabama at Birmingham
Zambia, Lusaka
University of Zambia School of Medicine
Kaseba, Christine M.
Zambia, Lusaka
University of Zambia School of Medicine
Levy, Jens W.
Zambia, Lusaka
Centre for Infectious Disease Research in Zambia
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Sinkala, Moses M.
Zambia, Lusaka
Centre for Infectious Disease Research in Zambia
Zambia, Lusaka
Catholic Medical Mission Board
Goldenberg, Robert L.
United States, Birmingham
The University of Alabama at Birmingham
Chi, Benjamin H.
Zambia, Lusaka
Centre for Infectious Disease Research in Zambia
United States, Birmingham
The University of Alabama at Birmingham
Zambia, Lusaka
University of Zambia School of Medicine
Matongo, Inutu
Zambia, Lusaka
Centre for Infectious Disease Research in Zambia
Vermund, Sten Havlor
United States, Nashville
Vanderbilt University School of Medicine
Mwanahamuntu, Mulindi H.
Zambia, Lusaka
University of Zambia School of Medicine
Stringer, Jeffrey S.A.
Zambia, Lusaka
Centre for Infectious Disease Research in Zambia
United States, Birmingham
The University of Alabama at Birmingham
Zambia, Lusaka
University of Zambia School of Medicine
Statistics
Citations: 233
Authors: 10
Affiliations: 6
Identifiers
Doi:
10.1016/j.ajog.2007.03.031
ISSN:
00029378
Research Areas
Environmental
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Locations
Zambia
Participants Gender
Female