Contraceptive Options For Women and Couples With HIV: Intrauterine Device (Iud or Iucd)
Contraceptive Options For Women and Couples With HIV: Intrauterine Device (Iud or Iucd)
Contraceptive Options For Women and Couples With HIV: Intrauterine Device (Iud or Iucd)
Copper T-380A
Types of IUDs
• Most common:
– T-shaped, copper bands on plastic stem/arms
Risk:
• Linked to skill and experience of provider
• Reduced through supervised training
• Greater for postpartum insertions performed
between 48 hours and 4 weeks after delivery
Source: Anteby, 1993; O’Hanley, 1992; Zhang, 1992; Petersen, 1991; Sivin, 1992.
IUDs Safe for Women with HIV
Little difference
in complications
between IUD
acceptors with
and without HIV.
Theoretical concern:
• IUD use by women with HIV may increase
risk of transmission to partner
Interval insertion
• Anytime during menstrual cycle if woman is not
pregnant
Postpartum insertion
• Immediately after vaginal or cesarean delivery if
no infection or bleeding (within 48 hours or delay
at least 4 weeks)
Postabortion insertion
• Immediately if no infection
Source: WHO, 2004; updated 2008.
IUD Counseling Topics
• Characteristics of IUDs
• Effectiveness and how IUDs work
• Common side effects
• Client’s risk of STIs
• Insertion and removal procedures
• Instructions for use and follow-up visit
(including signs of complications that require
immediate return to the clinic)
Counseling about IUD Side Effects:
What to Expect
During Insertion:
• Some pain and cramping
IUDs:
• Are not abortifacients
• Do not cause infertility
• Do not cause discomfort for the male partner
• Do not travel to distant parts of the body
• Are not too large for small women
IUDs are:
• Safe, effective, convenient, reversible,
long lasting, cost-effective, easy to use,
appropriate for the majority of women
Providers can ensure safety by:
• Informative counseling
• Careful screening
• Appropriate infection prevention
practices
• Proper follow-up