The levonorgestrel-releasing intrauterine system in human immunodeficiency virus-infected women: a 5-year follow-up study

OBJECTIVE: We sought to assess the effects of long-term use and safety of the levonorgestrel-releasing (LNG)-intrauterine system (IUS) among human immunodeficiency virus (HIV)-infected women in comparison with HIV-infected women not using the device. STUDY DESIGN: Fifteen women using the LNG-IUS and their 25 age- and CD4(+) lymphocyte count-matched control subjects with annual follow-up data were followed up for 5 years. RESULTS: No unplanned pregnancies or pelvic infections occurred among the LNG-IUS users. Altogether, 12 (80%) of the LNG-IUS users continued its use up to 5 years. Annual CD4(+) lymphocyte counts were similar in the LNG-IUS users and control subjects throughout the follow-up period. The hemoglobin levels increased initially (P<.005) and remained higher among the LNG-IUS users (P<.02). Pap smears displayed non-squamous intraepithelial lesion cytology in >= 85% of cases in both groups. CONCLUSION: No unfavorable effects on the course of HIV infection were noted during long-term use of the LNG-IUS. Dual protection by means of an LNG-IUS and condoms might be an ideal contraceptive strategy for HIV-infected women.