Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Sex Transm Dis. 2010 Jun;37(6):356-60. doi: 10.1097/OLQ.0b013e3181d40ff1.
The role of hormonal contraception on acquisition of gonorrhea has not been well-characterized, as the transmission dynamics of Neisseria gonorrhoeae are poorly understood. The purpose of this study is to determine the influence of hormonal contraception on gonococcal infection in women exposed to males with gonococcal urethritis.
Females aged 15 to 35 years reporting sexual contact to a male partner diagnosed with N. gonorrhoeae were enrolled. Demographic and sexual histories, physical findings, and laboratory tests were collected. Women testing positive and negative for cervical N. gonorrhoeae were compared using chi and Fisher exact tests, with multivariable logistic regression performed on those factors independently associated with gonococcal infection on univariate analysis.
N. gonorrhoeae infection occurred in 68 of 107 (64%) women. Women using combined hormonal contraception were significantly less likely than nonusers to test positive for N. gonorrhoeae (32% vs. 76%; prevalence ratio: 0.42; 95% confidence interval: 0.22, 0.78; P = 0.006). Gonorrhea was also less common in depomedroxyprogesterone acetate users. A new sexual partner was also associated with testing positive for gonorrhea (35% vs. 13%; prevalence ratio: 1.47; 95% confidence interval: 1.13, 1.90; P = 0.004).
Women using combined hormonal contraceptives or depomedroxyprogesterone acetate were less likely to test positive for N. gonorrhoeae after sexual exposure compared with nonusers. Our data suggest that, in addition to contraceptive benefits, modern hormonal contraception may have a protective effect on the acquisition of N. gonorrhoeae.
由于淋病奈瑟菌的传播动力学尚未得到很好的理解，因此激素避孕对淋病感染的作用尚未得到充分描述。本研究旨在确定激素避孕对接触患有淋病尿道炎男性的女性感染淋球菌的影响。
招募了年龄在 15 至 35 岁之间，报告与被诊断为淋病奈瑟菌的男性有性接触的女性。收集人口统计学和性史、体格检查和实验室检查结果。对宫颈淋病奈瑟菌检测阳性和阴性的女性进行 χ2 和 Fisher 确切检验比较，对单变量分析中与淋球菌感染独立相关的因素进行多变量逻辑回归。
107 名女性中有 68 名（64%）感染了淋病奈瑟菌。与非使用者相比，使用复方激素避孕药的女性检测淋病奈瑟菌阳性的可能性显著降低（32% vs. 76%；患病率比：0.42；95%置信区间：0.22，0.78；P = 0.006）。醋酸甲羟孕酮使用者的淋病也较少见。新性伴侣也与淋病检测阳性相关（35% vs. 13%；患病率比：1.47；95%置信区间：1.13，1.90；P = 0.004）。
与非使用者相比，在性接触后，使用复方激素避孕药或醋酸甲羟孕酮的女性检测淋病奈瑟菌阳性的可能性较低。我们的数据表明，除了避孕益处外，现代激素避孕药可能对淋病奈瑟菌的获得具有保护作用。
