{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T08:41:12Z","timestamp":1770453672990,"version":"3.49.0"},"reference-count":17,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T00:00:00Z","timestamp":1578528000000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2019,12,10]]},"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To review systematically copper intrauterine device (Cu-IUD) use and HIV acquisition in women.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We searched Pubmed, Embase and the Cochrane Library between database inception and 26 June 2019 for longitudinal studies comparing incident HIV infection among women using an unspecified IUD or Cu-IUD compared with non-hormonal or no contraceptive users, or hormonal contraceptive users. We extracted information from included studies, assessed study quality, and summarised study findings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From 2494 publications identified, seven met our inclusion criteria. One randomised controlled trial (RCT), judged \u201cinformative with few limitations\u201d, found no statistically significant differences in HIV risk between users of the Cu-IUD and either intramuscular depot medroxyprogesterone acetate (DMPA-IM) or levonorgestrel implant. One observational study, deemed \u201cinformative but with important limitations\u201d, found no statistically significant difference in HIV incidence among IUD users compared with women who had tubal ligation or who were not using any contraception. Another \u201cinformative but with important limitations\u201d observational study found no difference in HIV incidence between Cu-IUD users and DMPA or norethisterone enanthate injectable, or implant users. An RCT considered \u201cunlikely to inform the primary question\u201d also found no difference in HIV risk between Cu-IUD and progestogen-only injectable users. Findings from the other three \u201cunlikely to inform the primary question\u201d cohort studies were consistent with the more robust studies suggesting no increased risk of HIV acquisition among Cu-IUD users.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The collective evidence, including that from a large high-quality RCT, does not indicate an increased risk of HIV acquisition among users of Cu-IUDs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2019-200512","type":"journal-article","created":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T13:55:12Z","timestamp":1578578112000},"page":"17-25","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Copper intrauterine device use and HIV acquisition in women: a systematic review"],"prefix":"10.1136","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2588-1006","authenticated-orcid":false,"given":"Philip C","family":"Hannaford","sequence":"first","affiliation":[{"name":"Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angeline","family":"Ti","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsungai","family":"Chipato","sequence":"additional","affiliation":[{"name":"University of Zimbabwe College of Health Sciences, Harare, Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5892-3786","authenticated-orcid":false,"given":"Kathryn M","family":"Curtis","sequence":"additional","affiliation":[{"name":"Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,1,9]]},"reference":[{"key":"2025090512213771000_46.1.17.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31288-7"},{"key":"2025090512213771000_46.1.17.2","doi-asserted-by":"crossref","first-page":"489.e1","DOI":"10.1016\/j.ajog.2014.05.016","article-title":"Changes in genital tract immune cell populations after initiation of intrauterine contraception","volume":"211","author":"Achilles","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"2025090512213771000_46.1.17.3","doi-asserted-by":"publisher","DOI":"10.1089\/aid.1996.12.333"},{"key":"2025090512213771000_46.1.17.4","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00899-07"},{"key":"2025090512213771000_46.1.17.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"2025090512213771000_46.1.17.6","unstructured":"Covidence Systematic Review Software . Veritas health information 2019."},{"key":"2025090512213771000_46.1.17.7","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1136\/bmjsrh-2019-200509","article-title":"Hormonal contraception and HIV acquisition among women: an updated systematic review","volume":"46","author":"Curtis","year":"2020","journal-title":"BMJ Sex Reprod Health"},{"key":"2025090512213771000_46.1.17.8","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001228"},{"key":"2025090512213771000_46.1.17.9","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1097\/QAD.0000000000002260","article-title":"Risk of HIV-1 acquisition among South African women using a variety of contraceptive methods in a prospective study","volume":"33","author":"Palanee-Phillips","year":"2019","journal-title":"AIDS"},{"key":"2025090512213771000_46.1.17.10","article-title":"Risk of HIV-1 acquisition among South African women using a variety of contraceptive methods in a prospective study (Abstract)","volume":"34","author":"Baeten","year":"2018","journal-title":"AIDS Res Hum Retroviruses"},{"key":"2025090512213771000_46.1.17.11","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1097\/00126334-199305000-00010","article-title":"Man-to-woman sexual transmission of HIV: longitudinal study of 343 steady partners of infected men","volume":"6","author":"Saracco","year":"1993","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2025090512213771000_46.1.17.12","doi-asserted-by":"publisher","DOI":"10.1258\/0956462961917104"},{"key":"2025090512213771000_46.1.17.13","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199801000-00009"},{"key":"2025090512213771000_46.1.17.14","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200403050-00017"},{"key":"2025090512213771000_46.1.17.15","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc-2016-101607"},{"key":"2025090512213771000_46.1.17.16","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1991.00400120055009"},{"key":"2025090512213771000_46.1.17.17","unstructured":"World Health Organization . Contraceptive eligibility for women at high risk of HIV. Geneva, Switzerland: World Health Organization, 2019. https:\/\/www.who.int\/reproductivehealth\/publications\/contraceptive-eligibility-women-at-high-risk-of-HIV\/en\/. (Accessed September 13, 2019)."}],"container-title":["BMJ Sexual &amp; Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsrh-2019-200512","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T19:21:43Z","timestamp":1757100103000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/bmjsrh-2019-200512"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1,9]]},"published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1136\/bmjsrh-2019-200512"],"URL":"https:\/\/doi.org\/10.1136\/bmjsrh-2019-200512","relation":{},"ISSN":["2515-1991","2515-2009"],"issn-type":[{"value":"2515-1991","type":"print"},{"value":"2515-2009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}