Advertisement

Sexually Transmitted Infections and Contraceptive Use in Adolescents

Published:February 18, 2020DOI:https://doi.org/10.1016/j.amepre.2019.11.012

      Introduction

      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.

      Methods

      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.

      Results

      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).

      Conclusions

      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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • Ventura SJ
        • Hamilton BE
        • Mathews TJ
        • Centers for Disease Control and Prevention (CDC)
        Pregnancy and childbirth among females aged 10–19 years — United States, 2007–2010.
        MMWR Suppl. 2013; 62: 71-76
        • Guttmacher Institute
        American teens’ sexual and reproductive health.
        Published 2014
        • WHO
        Adolescent pregnancy.
        Published 2014
        • Mathews TJ
        • MacDorman MF
        Infant mortality statistics from the 2008 period linked birth/infant death data set.
        Natl Vital Stat Rep. 2012; 60: 1-27
        www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_05.pdf
        Date accessed: November 14, 2019
        • Martin JA
        • Hamilton BE
        • Ventura SJ
        • et al.
        Births: final data for 2009.
        Natl Vital Stat Rep. 2011; 60: 1-70
        www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdf
        Date accessed: November 14, 2019
        • National Campaign to Prevent Teen and Unplanned Pregnancy
        Counting it up: the public costs of teen childbearing.
        Key data. Published December 2013;
      1. Planned parenthood. www.plannedparenthood.org/. Accessed May 20, 2018.

        • A Step Ahead Foundation
        A Step Ahead Foundation mission.
        Published 2011
        www.astepaheadfoundation.org/
        Date accessed: May 21, 2018
        • Ventura SJ
        • Mathews TJ
        • Hamilton BE
        • Sutton PD
        • Abma JC
        Centers for Disease Control and Prevention (CDC). Adolescent pregnancy and childbirth—United States, 1991–2008.
        MMWR Suppl. 2011; 60: 105-108
        www.cdc.gov/mmwr/preview/mmwrhtml/su6001a23.htm
        Date accessed: November 14, 2019
        • CDC
        Birth control methods.
        Published 2016
        www.cdc.gov/reproductivehealth/contraception/
        Date accessed: December 8, 2016
      2. American Congress of Obstetricians and Gynecologists. Adolescents and long-acting reversible contraception: implants and intrauterine devices. ACOG Committee Decision No. 539.https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Adolescents-and-Long-Acting-Reversible-Contraception?IsMobileSet=false. Published 2012. Accessed April 30, 2019.

        • Romero L
        • Pazol K
        • Warner L
        • et al.
        Vital Signs: trends in use of long-acting reversible contraception among teens aged 15‒19 years seeking contraceptive services: United States, 2005‒2013.
        MMWR Morb Mortal Wkly Rep. 2015; 64: 363-369
        • Dickerson LM
        • Diaz VA
        • Jordon J
        • et al.
        Satisfaction, early removal, and side effects associated with long-acting reversible contraception.
        Fam Med. 2013; 45: 701-707
        • McNicholas CP
        • Klugman JB
        • Zhao Q
        • Peipert JF
        Condom use and incident sexually transmitted infection after initiation of long-acting reversible contraception.
        Am J Obstet Gynecol. 2017; 217: 672.e1-672.e6
        • Steiner RJ
        • Liddon N
        • Swartzendruber AL
        • Rasberry CN
        • Sales JM
        Long-acting reversible contraception and condom use among female U.S. high school students: implications for sexually transmitted infection prevention.
        JAMA Pediatr. 2016; 170: 428-434
        • Frost JJ
        • Singh S
        • Finer LB
        U.S. women's one‐year contraceptive use patterns, 2004.
        Perspect Sex Reprod Health. 2007; 39: 48-55
        • Stevens J
        • Berlan ED
        Applying principles from behavioral economics to promote long‐acting reversible contraceptive (LARC) methods.
        Perspect Sex Reprod Health. 2014; 46: 165-170
        • Cates Jr, W
        • Steiner MJ
        Dual protection against unintended pregnancy and sexually transmitted infections: what is the best contraceptive approach?.
        Sex Transm Dis. 2002; 29: 168-174
        • Pazol K
        • Kramer MR
        • Hogue CJ
        Condoms for dual protection: patterns of use with highly effective contraceptive methods.
        Public Health Rep. 2010; 125: 208-217
        • CDC
        Clinical prevention guidance.
        Published 2017
        www.cdc.gov/std/tg2015/clinical.htm
        Date accessed: March 14, 2018
        • Grady WR
        • Billy JO
        • Klepinger DH
        Contraceptive method switching in the United States.
        Perspect Sex Reprod Health. 2002; 34: 135-145
        • American Academy of Pediatrics
        Contraception for adolescents.
        Pediatrics. 2014; 134: e1244-e1256