ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Elevated Risk of Bacterial Vaginosis Among Users of the Copper Intrauterine Device: A Prospective Longitudinal Cohort Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 42 citations in OpenAlex.
- Genital inflammatory status and the innate immune response to contraceptive initiation.American journal of reproductive immunology (New York, N.Y. : 1989) · 2022Trial
- The Impact of the Vaginal Microbiome and Microbial Metabolites on HIV Transmission at the Female Reproductive Tract Epithelial Barrier.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026Review
- Genomic Diversity of VaginalViruses · 2026Article
- Selective Human-Milk-Inspired Antimicrobial Peptides for the Treatment of Bacterial Vaginosis.Pharmaceutics · 2026Article
- Prior copper intrauterine device use and reproductive outcomes after embryo transfer in IVF/ICSI cycles: a propensity score-matched cohort study.Frontiers in cell and developmental biology · 2026Article
- Bacterial vaginosis: an overlooked STI?Expert review of anti-infective therapy · 2025Review
- Prevalence and associated risk factors of bacterial vaginosis among women of reproductive age living with, and without HIV in Lagos, Nigeria.BMC women's health · 2025Article
- Bacterial vaginosis.Nature reviews. Disease primers · 2025Review
- Article
- In Vitro Bactericidal Activity of a Neomycin-Polymyxin B-Nystatin Combination Compared to Metronidazole and Clindamycin Against the Main Bacteria Involved in Bacterial Vaginosis and Aerobic Vaginitis.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Risks of pelvic inflammatory disease and bacterial vaginosis in adenomyosis patients using levonorgestrel intrauterine device or oral norethindrone.Frontiers in endocrinology · 2025Article
- Contraceptives Association with Vaginal Microbiome and RTI: A Cross-Sectional Survey in Females of Jammu and Kashmir, India.Indian journal of microbiology · 2024Article
- Contraceptive effects on the cervicovaginal microbiome: Recent evidence including randomized trials.American journal of reproductive immunology (New York, N.Y. : 1989) · 2023Review
- Observational
- Understanding and Preventing Recurring Bacterial Vaginosis: Important Considerations for Clinicians.International journal of women's health · 2023Review
- Bacterial vaginosis: a review of approaches to treatment and prevention.Frontiers in reproductive health · 2023Review
- The Role of Antimicrobial Resistance in Refractory and Recurrent Bacterial Vaginosis and Current Recommendations for Treatment.Antibiotics (Basel, Switzerland) · 2022Review
- Article
- The impact of contraceptives on the vaginal microbiome in the non-pregnant state.Frontiers in microbiomes · 2022Review
- Treatment of Male Sexual Partners of Women With Bacterial Vaginosis: A Randomized, Double-Blind, Placebo-Controlled Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
Corrections and comments
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Authors and funding
15 authors at 8 institutions in 4 countries.
Funding
Abstract
backgroundLimited evidence suggests that the nonhormonal contraceptive copper intrauterine device (Cu-IUD) may increase bacterial vaginosis (BV) risk, possibly due to increased volume and duration of menses, a common side effect of Cu-IUD use. Although increases in bleeding typically resolve within 6-12 months following initiation, evaluations of the association between Cu-IUD and BV have not included more than 6 months of follow-up.
methodsThis secondary analysis of a human immunodeficiency virus type 1 prevention trial included 2585 African women ages 18-45 followed for up to 33 months. Women reported contraceptive use each month. BV was evaluated by Nugent score in 6-monthly intervals and, if clinically indicated, by Amsel criteria. Andersen-Gill proportional hazards models were used to (1) evaluate BV risk among Cu-IUD users relative to women using no/another nonhormonal contraceptive and (2) test changes in BV frequency before, while using, and following Cu-IUD discontinuation.
resultsBV frequency was highest among Cu-IUD users at 153.6 episodes per 100 person-years (95% confidence interval [CI]: 145.2, 162.4). In adjusted models, Cu-IUD users experienced 1.28-fold (95% CI: 1.12, 1.46) higher BV risk relative to women using no/another nonhormonal contraception. Compared to the 6 months prior to initiation, BV risk was 1.52-fold (95% CI: 1.16, 2.00) higher in the first 6 months of Cu-IUD use and remained elevated over 18 months of use (P < .05). Among women who discontinued Cu-IUD, BV frequency was similar to pre-initiation rates within 1 year.
conclusionsCu-IUD users experienced elevated BV risk that persisted throughout use. Women and their providers may wish to consider BV risk when discussing contraceptive options.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.