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A Randomized Trial of IUD Versus Hormonal Contraception in HIV-infected Women in Zambia

This study has been completed.
Sponsor:
Collaborators:
Elizabeth Glaser Pediatric AIDS Foundation
United States Agency for International Development (USAID)
Information provided by:
University of Alabama at Birmingham
ClinicalTrials.gov Identifier:
NCT00336245
First received: June 11, 2006
Last updated: August 11, 2009
Last verified: August 2009

June 11, 2006
August 11, 2009
June 2002
October 2005   (final data collection date for primary outcome measure)
Incident pregnancy
Same as current
Complete list of historical versions of study NCT00336245 on ClinicalTrials.gov Archive Site
  • Safety
  • Method discontinuation rates
Same as current
Not Provided
Not Provided
 
A Randomized Trial of IUD Versus Hormonal Contraception in HIV-infected Women in Zambia
A Randomized Trial of IUD Versus Hormonal Contraception in HIV-infected Women in Zambia

A randomized trial of the intrauterine contraceptive device (IUD) versus user's choice hormonal contraception (injectable progestins or oral contraceptive pills) among HIV-infected, recently post-partum women in Lusaka, Zambia.

In the year 2000, there were over 37, 000 new acceptors of family planning in the Lusaka District Clinics. A variety of methods were prescribed, including combined oral contraceptive pills, injectable progestins, the intrauterine copper device, condoms, and others. The most recent sentinel survey of reproductive age women estimated that approximately 30% of reproductive age women in Lusaka are HIV-infected. Since voluntary HIV counseling and testing is not yet universally available in many of the district clinics, women receive all different types of contraception regardless of their HIV status.

There is some observational data published recently that suggests hormonal contraception may increase HIV viral load in the female genital tract and potentially increase HIV transmission to the male partner. By contrast, barrier methods have historically been very unpopular in stable couples and are not used consistently in many cases despite intensive counseling. The IUCD represents one of the most inexpensive and effective methods of birth control available in Lusaka. However, it has not been studied adequately to make policy recommendations regarding its use in HIV infected women. The purpose of this study will be to evaluate safety and acceptability of the IUCD versus hormonal methods of contraception in HIV-infected and uninfected women in Lusaka. Specifically, we will 1) compare the contraceptive effectiveness of the IUCD to the standard practices of user-chosen hormonal contraception, 2) compare the rates of pelvic infection between IUD and hormonal contraceptive users, and 3) compare rates of method discontinuation.

Patients who have a continuing second trimester pregnancy, serologically confirmed HIV infection, a desire for 24 months of contraception, and a willingness to be randomly assigned either an IUCD or hormonal contraception postpartum will be screened at 32 weeks in their pregnancies to receive either an IUCD or user chosen hormonal contraception postpartum. Women will then be seen at postpartum weeks 4-6 for method randomization and then at months 6, 12, 18 and 24 to monitor pregnancy, continuation of method, side effects and any other problems. Women will be encouraged to return for problems at any time. At least once yearly, women will have a complete physical exam. CD4 and HIV clinical status will be monitored regularly.

Interventional
Phase 3
Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Prevention
  • Pregnancy
  • HIV Infection
  • Device: Copper T Intrauterine Contraceptive Device
  • Drug: Hormonal Contraception
Not Provided
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
600
October 2005
October 2005   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • desire for at least 2 years of continuous contraception
  • two or fewer sexual partners in the prior year

Exclusion Criteria:

  • advanced HIV disease (WHO Stage III or IV)
  • history of a bleeding disorder
  • history of PID within the prior five years
  • less than 16 years of age (the "age of majority" in Zambia).
Female
16 Years and older
No
Contact information is only displayed when the study is recruiting subjects
Not Provided
 
NCT00336245
EGPAF PG-51161
Not Provided
Not Provided
University of Alabama at Birmingham
  • Elizabeth Glaser Pediatric AIDS Foundation
  • United States Agency for International Development (USAID)
Principal Investigator: Jeffrey Stringer, MD University of Alabama at Birmingham
University of Alabama at Birmingham
August 2009

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP