Hofmeyr G Justus, Singata Mandisa, Lawrie Theresa A
Department of Obstetrics and Gynaecology, East London Hospital Complex, University of the Witwatersrand, University of Fort Hare, Eastern Cape Department of Health, Frere and Cecilia Makiwane Hospitals, Private Bag X 9047, East London, Eastern Cape, South Africa, 5200.
Cochrane Database Syst Rev. 2010 Jun 16;2010(6):CD007043. doi: 10.1002/14651858.CD007043.pub2.
Highly effective contraception is essential to reduce unintended pregnancies and the effect these have on individuals, society and public health resources. Intrauterine devices (IUDs) and depot progestogens are two commonly used long-acting, reversible contraceptive methods with different risk and benefit profiles.
To compare the contraceptive and non-contraceptive benefits and risks of using the copper-containing IUD versus depot progestogens for contraception.
In June 2009 we searched the Cochrane Pregnancy and Childbirth Group Trials Register, the Cochrane Central Register of Controlled Trials, Pubmed, Popline, Clinical Trials.gov, the Current Controlled Trials metaRegister, EMBASE and LILACS, and contacted study authors.
Randomized trials comparing women using copper-containing IUDs with women using depot progestogens.
We assessed eligibility and trial quality, extracted and double-entered data.
Two studies were included in the review. In the one study in HIV infected women, the IUD was compared with depot progestogen or the oral contraceptive, according to the women's choice. As the majority of women chose depot progestogen, we have included this study in the review, within a mixed hormonal contraception sub-group.Overall, the copper IUD was more effective than depot progestogens/hormonal contraception at preventing pregnancy (risk ratio (RR) 0.45; 95% confidence interval (CI) 0.24 to 0.84). HIV disease progression was reduced in the IUD group (RR 0.58; 95% CI 0.39 to 0.87). There was no significant difference in pelvic inflammatory disease rates between the two groups. Discontinuation of the allocated method was less frequent with the IUD in one study, and less frequent with hormonal contraception in the other study (in which women were allowed to switch between various hormonal methods).
AUTHORS' CONCLUSIONS: In the populations studied, the IUD was more effective than hormonal contraception with respect to pregnancy prevention. High quality research is urgently needed to compare the effects, if any, of these two commonly used contraception methods on HIV acquisition/seroconversion and HIV/AIDS disease progression.
高效避孕对于减少意外怀孕及其对个人、社会和公共卫生资源的影响至关重要。宫内节育器（IUD）和长效孕激素是两种常用的长效可逆避孕方法，具有不同的风险和益处。
比较含铜宫内节育器与长效孕激素用于避孕的避孕及非避孕益处和风险。
2009年6月，我们检索了Cochrane妊娠与分娩组试验注册库、Cochrane对照试验中央注册库、PubMed、Popline、ClinicalTrials.gov、当前对照试验元注册库、EMBASE和LILACS，并联系了研究作者。
比较使用含铜宫内节育器的女性与使用长效孕激素的女性的随机试验。
我们评估了纳入资格和试验质量，提取并双份录入数据。
本综述纳入了两项研究。在一项针对感染HIV女性的研究中，根据女性的选择，将宫内节育器与长效孕激素或口服避孕药进行了比较。由于大多数女性选择了长效孕激素，我们将该研究纳入了综述，置于混合激素避孕亚组内。总体而言，含铜宫内节育器在预防妊娠方面比长效孕激素/激素避孕更有效（风险比（RR）0.45；95%置信区间（CI）0.24至0.84）。宫内节育器组的HIV疾病进展有所减少（RR 0.58；95%CI 0.39至0.87）。两组盆腔炎发生率无显著差异。在一项研究中，宫内节育器组分配方法的停用频率较低，而在另一项研究中（其中女性可在各种激素方法之间切换），激素避孕组的停用频率较低。
在所研究的人群中，宫内节育器在预防妊娠方面比激素避孕更有效。迫切需要高质量的研究来比较这两种常用避孕方法对HIV感染/血清转化和HIV/AIDS疾病进展的影响（如有）。
