Intrauterine Devices and Sexually Transmitted Infection among Older Adolescents and Young Adults in a Cluster Randomized Trial - 30/04/21
, Corinne H. Rocca, PhD 1, Sarah H. Averbach, MD 1, 2, Suzan Goodman, MD 1, Philip D. Darney, MD 1, Ashlesha Patel, MD 3, Cynthia C. Harper, PhD 1Abstract |
Study Objective |
Provider misconceptions regarding intrauterine device (IUD) safety for adolescents and young women can unnecessarily limit contraceptive options offered; we sought to evaluate rates of Neisseria gonorrhoeae or Chlamydia trachomatis (GC/CT) diagnoses among young women who adopted IUDs.
Design |
Secondary analysis of a cluster-randomized provider educational trial.
Setting |
Forty US-based reproductive health centers.
Participants |
We followed 1350 participants for 12 months aged 18-25 years who sought contraceptive care.
Interventions |
The parent study assessed the effect of provider training on evidence-based contraceptive counseling.
Main Outcome Measures |
We assessed incidence of GC/CT diagnoses according to IUD use and sexually transmitted infection risk factors using Cox regression modeling and generalized estimating equations.
Results |
Two hundred four participants had GC/CT history at baseline; 103 received a new GC/CT diagnosis over the 12-month follow-up period. IUDs were initiated by 194 participants. Incidence of GC/CT diagnosis was 10.0 per 100 person-years during IUD use vs 8.0 otherwise. In adjusted models, IUD use (adjusted hazard ratio [aHR], 1.31; 95% confidence interval [CI], 0.71-2.40), adolescent age (aHR, 1.28; 95% CI, 0.72-2.27), history of GC/CT (aHR, 1.23; 95% CI, 0.75-2.00), and intervention status (aHR, 1.12; 95% CI, 0.74-1.71) were not associated with GC/CT diagnosis; however, new GC/CT diagnosis rates were significantly higher among individuals who reported multiple partners at baseline (aHR, 2.0; 95% CI, 1.34-2.98).
Conclusion |
In this young study population with GC/CT history, this use of IUDs was safe and did not lead to increased GC/CT diagnoses. However, results highlighted the importance of dual sexually transmitted infection and pregnancy protection for participants with multiple partners.
Le texte complet de cet article est disponible en PDF.Key Words : Adolescent, Contraception, Intrauterine device, Neisseria gonorrhoeae, Chlamydia trachomatis, Sexually transmitted diseases
Plan
| The authors indicate no conflicts of interest. |
Vol 34 - N° 3
P. 355-361 - juin 2021 Retour au numéro
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