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.
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Article info
Publication history
Published online: February 18, 2020
Identification
Copyright
© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
