Baeten J M, Nyange P M, Richardson B A, Lavreys L, Chohan B, Martin H L, Mandaliya K, Ndinya-Achola J O, Bwayo J J, Kreiss J K
Department of Epidemiology, University of Washington, Seattle, WA 98104-2499, USA.
Am J Obstet Gynecol. 2001 Aug;185(2):380-5. doi: 10.1067/mob.2001.115862.
To examine the relationship between use of oral contraceptive pills or depot medroxyprogesterone acetate and sexually transmitted disease acquisition.
Prospective cohort included 948 Kenyan prostitutes. Multivariate Andersen-Gill proportional hazards models were constructed, adjusting for sexual behavioral and demographic variables.
When compared with women who were using no contraception, users of oral contraceptive pills were at increased risk for acquisition of chlamydia (hazard ratio, 1.8; 95% confidence interval, 1.1-2.9) and vaginal candidiasis (hazard ratio, 1.5; 95% confidence interval, 1.2-1.9) and at decreased risk for bacterial vaginosis (hazard ratio, 0.8; 95% confidence interval, 0.7-1.0). Women using depot medroxyprogesterone acetate had significantly increased risk of chlamydia infection (hazard ratio, 1.6; 95% confidence interval, 1.1-2.4) and significantly decreased risk of bacterial vaginosis (hazard ratio, 0.7; 95% confidence interval, 0.5-0.8), trichomoniasis (hazard ratio, 0.6; 95% confidence interval, 0.4-1.0), and pelvic inflammatory disease (hazard ratio, 0.4; 95% confidence interval, 0.2-0.7). Consistent condom use was associated with significantly decreased risk of gonorrhea, chlamydia, genital ulcer disease, bacterial vaginosis, and pelvic inflammatory disease.
The use of oral or injectable hormonal contraception altered susceptibility to sexually transmitted diseases, which may in turn influence transmission of human immunodeficiency virus type 1. Consistent condom use was protective with regards to sexually transmitted disease and should be encouraged for the prevention of sexually transmitted disease and human immunodeficiency virus type 1 among women who use hormonal contraception.
研究口服避孕药或醋酸甲羟孕酮长效避孕针的使用与性传播疾病感染之间的关系。
前瞻性队列研究纳入了948名肯尼亚妓女。构建多变量安德森-吉尔比例风险模型，并对性行为和人口统计学变量进行校正。
与未采取避孕措施的女性相比，口服避孕药使用者感染衣原体的风险增加（风险比为1.8；95%置信区间为1.1 - 2.9），患阴道念珠菌病的风险增加（风险比为1.5；95%置信区间为1.2 - 1.9），患细菌性阴道病的风险降低（风险比为0.8；95%置信区间为0.7 - 1.0）。使用醋酸甲羟孕酮长效避孕针的女性感染衣原体的风险显著增加（风险比为1.6；95%置信区间为1.1 - 2.4），患细菌性阴道病、滴虫病和盆腔炎的风险显著降低（风险比分别为0.7；95%置信区间为0.5 - 0.8、0.6；95%置信区间为0.4 - 1.0、0.4；95%置信区间为0.2 - 0.7）。持续使用避孕套与淋病、衣原体感染、生殖器溃疡疾病、细菌性阴道病和盆腔炎的风险显著降低相关。
口服或注射用激素避孕会改变对性传播疾病的易感性，这反过来可能会影响1型人类免疫缺陷病毒的传播。持续使用避孕套对性传播疾病具有保护作用，对于使用激素避孕的女性，应鼓励其使用避孕套以预防性病和1型人类免疫缺陷病毒感染。
