title: Positive Testing for Neisseria gonorrhoeae and Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease in IUD Users.
abstract: BACKGROUND
  Unintended pregnancies are a major public health problem in the United States, and intrauterine devices (IUDs) are among the most effective reversible birth control methods available. Historically, there have been concerns about IUD use and infection among young and/or high-risk women that may increase the risk of pelvic inflammatory disease (PID) and subsequent infertility.
  
  
  METHODS
  The Contraceptive CHOICE Project (CHOICE) was a prospective cohort study of over 9,000 women 14-45 years of age residing in the St. Louis area who were interested in initiating a new form of reversible contraception. At enrollment, participants were counseled regarding long-acting contraceptive methods with the goal of increasing awareness of all reversible methods available. Participants were also tested for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) during enrollment and were provided with contraception at no cost for 2-3 years.
  
  
  RESULTS
  We estimate the frequency of self-reported PID in new IUD users compared with women using other contraceptive methods. Among both new IUD users who tested positive for GC and/or CT and those who tested negative, the PID rate was 1% or below.
  
  
  CONCLUSIONS
  Our results demonstrate that IUD use is safe for all women, including women at high risk for sexually transmitted infections.
authors.affiliation: This research was presented in part at the Annual Meeting of the Infectious Diseases Society in Obstetrics and Gynecology, August 7, 2010, Santa Fe, New Mexico.
authors.forename: Natalia E
authors.initials: NE
authors.lastname: Birgisson
authors.forename: Qiuhong
authors.initials: Q
authors.lastname: Zhao
authors.forename: Gina M
authors.initials: GM
authors.lastname: Secura
authors.forename: Tessa
authors.initials: T
authors.lastname: Madden
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Peipert
mesh_terms: D000293:Adolescent; D000328:Adult; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D003267:Contraception / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007246:Infertility; D007434:Intrauterine Devices / Q000009:adverse effects*; D008875:Middle Aged; D008923:Missouri; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D000292:Pelvic Inflammatory Disease / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D055815:Young Adult
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