Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
A Step Ahead Foundation, Memphis, Tennessee.
Am J Prev Med. 2020 Apr;58(4):536-546. doi: 10.1016/j.amepre.2019.11.012. Epub 2020 Feb 17.
Although a number of contraception methods exist, long-acting reversible contraceptives have been recommended for female adolescents owing to their low failure rates. However, concern exists that the increasing use of long-acting reversible contraceptive among female adolescents may have unintended consequences of decreasing condom use for the prevention of sexually transmitted infections. Despite this concern, few studies have directly explored the relationship between the use of long-acting reversible contraceptive versus other forms of contraception and diagnosis of sexually transmitted infections in female adolescents. This study compares the rates of sexually transmitted infection diagnosis following various forms of contraceptive use.
This study was an archival data analysis of single state Medicaid claims retrieved for female adolescents, aged 14-19 years, who received a contraceptive prescription and had 1 year of follow-up data available (n=62,550) between 2011 and 2015. Incidence of sexually transmitted infections was the outcome of interest. Data analysis was conducted in 2018.
Compared with the contraceptive pill, hormonal implant (a form of long-acting reversible contraceptives) was associated with significantly lower risk of sexually transmitted infections (hazard ratio=0.81; 95% CI=0.70, 0.93; p=0.004), and hormonal injection was associated with higher risk of sexually transmitted infections (hazard ratio=1.08; 95% CI=1.00, 1.16; p=0.040).
This analysis provides strong evidence that the risk for the acquisition of sexually transmitted infections is no higher for long-acting reversible contraceptives than for other forms of contraception. These results support the use of long-acting reversible contraceptive in female adolescents, as proposed and reaffirmed by the American College of Obstetricians and Gynecologists and American Academy of Pediatrics.
尽管有许多避孕方法可供选择，但长效可逆避孕方法由于其低失败率而被推荐给女性青少年。然而，人们担心女性青少年中长效可逆避孕方法的使用增加可能会导致避孕套用于预防性传播感染的使用减少。尽管存在这种担忧，但很少有研究直接探讨长效可逆避孕方法与其他避孕方法的使用与女性青少年性传播感染诊断之间的关系。本研究比较了各种避孕方法使用后性传播感染诊断的发生率。
这是一项对 2011 年至 2015 年间在一个州的医疗补助计划索赔中进行的档案数据分析，研究对象为年龄在 14-19 岁之间、接受避孕处方且有 1 年随访数据（n=62550）的女性青少年。性传播感染的发生率是本研究的观察结果。数据分析于 2018 年进行。
与避孕药相比，激素植入物（一种长效可逆避孕方法）与性传播感染的风险显著降低相关（风险比=0.81；95%CI=0.70，0.93；p=0.004），而激素注射与性传播感染的风险增加相关（风险比=1.08；95%CI=1.00，1.16；p=0.040）。
这项分析提供了强有力的证据表明，长效可逆避孕方法的性传播感染风险并不高于其他避孕方法。这些结果支持美国妇产科医师学会和美国儿科学会提出和重申的在女性青少年中使用长效可逆避孕方法。
