Contraceptives Association with Vaginal Microbiome and RTI: A Cross-Sectional Survey in Females of Jammu and Kashmir, India.

The present study aimed to examine the impacts of use of various contraceptive methods on vaginal microbiome and reproductive tract infections (RTI) in females. A cross-sectional study in Jammu Province of Jammu and Kashmir was conducted in which 796 sexually active married women of reproductive age were recruited as participants. A well-structured questionnaire was used to collect the data and the analysis was performed using linear and binary logistic regression with 95% confidence interval (CI). The value of < 0.05 was considered as significant. Previous studies have consistently shown that disturbances in the vaginal microbiome can lead to reproductive tract infections in women. The prevalence of contraceptive use and RTI in the studied population was 53.1% (CI 49.6-56.7%) and 44.7% (CI 41.2-48.3%) respectively. Several sociodemographic factors like age, place of residence, educational qualification, religion, and caste of the participant significantly governed the method of contraception used by the females. It was observed from the data obtained that the use of condoms and hormonal oral contraceptives reduced the risk of RTI as they maintain vaginal eubiosis in the females by 1.97-folds (AOR:1.97; CI 1.02-2.86) and 1.68 folds (AOR:1.68; CI 0.78-2.50) respectively. The likelihood of developing RTI increased by 2.31 (AOR:2.31; CI 1.05-3.57), 3.62 (AOR:1.97; CI 1.02-2.86), and 4.97 (AOR:4.97; CI 3.50-6.00) folds in females who opted for IUDs, tubal ligation, and unprotected sex respectively, these methods may interfere with the host vaginal microbiome, alter it and making the female more susceptible to the microbial infections and pathogenic attack. The research proposes that the use of hormonal oral contraceptives and condoms as the means of contraception is a safe method and the females opting for them are less prone to RTI.