Uptake and continuous use of copper intrauterine device in a cohort of HIV-positive women

Abstract

Copper intrauterine device (IUD) is not commonly used in many countries, though it provides effective reversible contraception with no or minimal primary systemic side effects. We assessed its uptake and continuation of use among HIV-positive Thai women. Sixty-six of 322 women of reproductive age, whom we approached for the study, met the eligibility criteria. Sterilization (62%) was the main reason for failure to enroll. Twenty-nine of them (44%) underwent IUD insertion. Considering condom use sufficient for pregnancy prevention (12%) was the main reason among eligible women for the refusal to participate in the study. At six months, 54% of enrolled participants reported one or more side effects such as increased menstrual flow (43%), spotting (21%) and dysmenorrhea (11%). The continuation rate of IUD use was high (93%), in spite of the persistent non-systemic side effects. The study showed that copper IUD could be an acceptable contraceptive choice for Thai HIV-positive women. Easy access to the method in a setting linked with the HIV service, and education on IUD risks and benefits is needed to promote the use of IUD in addition to condoms as an effective contraceptive option in HIV-infected women.

Keywords:

• uptake of intrauterine device
• continuous contraceptive use
• family planning
• HIV-positive women

Acknowledgements

The research was funded under the Cluster Ratchadapisek Sompotch Endowment Fund, Chulalongkorn University, grant No: H-31-91-53 and HIV-NAT. We thank Ms. Rosalin Kriengsinyot for her work on counceling the women on IUD advantages and disadvantages. We are grateful to the research and clinical staff and clients at the HIV-NAT Clinic and at the Thai Red Cross Anonymous Clinic for their contribution to this study.