Whether women with HIV are at increased risk for HIV remains controversial. An Italian cross-sectional study reported an increased risk of HIV acquisition in IUD users. Also, the increased menstrual flow and duration seen in nonprogesterone containing IUDs may increase transmission risk. The new levonorgestrel-containing IUD (Mirena), however, decreases menstrual flow and duration. There has been no increase in cervical HIV shedding in HIV-infected IUD users measured 4 months after IUD insertion. On the other hand, the IUD does not offer protection against either HIV or sexually transmitted infections.