Sexually transmitted infections among women randomised to depot medroxyprogesterone acetate, a copper intrauterine device or a levonorgestrel implant.
Sexually transmitted infections among women randomised to depot medroxyprogesterone acetate, a copper intrauterine device or a levonorgestrel implant.
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DOI：
10.1136/sextrans-2020-054590
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发表时间：
2021-06
影响因子：
3.6
通讯作者：
Morrison C
中科院分区：
文献类型：
--
作者：
Deese J;Philip N;Lind M;Ahmed K;Batting J;Beksinska M;Edward VA;Louw CE;Onono M;Palanee-Phillips T;Smit JA;Baeten JM;Donnell D;Mastro TD;Mugo NR;Nanda K;Rees H;Morrison C
育龄妇女面临怀孕和性传播感染 (STI) 的风险。了解性传播感染的驱动因素，包括与广泛使用的避孕药具的任何关联，可以帮助我们减少性传播感染的患病率和合并症。我们比较了随机采用三种避孕方法的女性的性传播感染风险。我们在一项临床试验中进行了二次分析，以评估衣原体和淋病的风险，该临床试验评估了 7829 名 16-35 岁女性的 HIV 风险，随机接受肌内长效醋酸甲羟孕酮 (DMPA-IM)、铜宫内节育器 (IUD) 或左炔诺孕酮 (LNG) 植入物。我们使用对数二项式回归按避孕组和患病率（PR）估计了衣原体和淋病的患病率。基线时，衣原体和淋病患病率分别为 18% 和 5%。最终访视衣原体患病率在 DMPA-IM 和含铜宫内节育器组之间或含铜宫内节育器和 LNG 植入组之间没有显着差异。与 LNG 植入组相比，DMPA-IM 组的衣原体风险显着降低（PR 0.83，95%CI 0.72 至 0.95）。最终访视淋病患病率仅在 DMPA-IM 组和含铜宫内节育器组之间存在显着差异（PR 0.67，95%CI 0.52 至 0.87）。研究结果表明，衣原体和淋病的风险可能因避孕方法的使用而异。有必要进行进一步的研究，以更好地了解避孕药具使用中衣原体和淋病的易感性机制。
Reproductive aged women are at risk of pregnancy and sexually transmitted infections (STI). Understanding drivers of STI acquisition, including any association with widely used contraceptives, could help us to reduce STI prevalence and comorbidities. We compared the risk of STI among women randomised to three contraceptive methods. We conducted a secondary analysis to assess the risk of chlamydia and gonorrhoea in a clinical trial evaluating HIV risk among 7829 women aged 16–35 randomised to intramuscular depot medroxyprogesterone acetate (DMPA-IM), a copper intrauterine device (IUD) or a levonorgestrel (LNG) implant. We estimated chlamydia and gonorrhoea prevalences by contraceptive group and prevalence ratios (PR) using log-binomial regression. At baseline, chlamydia and gonorrhoea prevalences were 18% and 5%, respectively. Final visit chlamydia prevalence did not differ significantly between DMPA-IM and copper IUD groups or between copper IUD and LNG implant groups. The DMPA-IM group had significantly lower risk of chlamydia compared with the LNG implant group (PR 0.83, 95% CI 0.72 to 0.95). Final visit gonorrhoea prevalence differed significantly only between the DMPA-IM and the copper IUD groups (PR 0.67, 95% CI 0.52 to 0.87). The findings suggest that chlamydia and gonorrhoea risk may vary with contraceptive method use. Further investigation is warranted to better understand the mechanisms of chlamydia and gonorrhoea susceptibility in the context of contraceptive use.
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影响因子：
168.9
作者：
Baeten, Jared M.;Donnell, Deborah;Stringer, Jeffrey
通讯作者：
Stringer, Jeffrey
影响因子：
3.7
作者：
Garrett, Nigel J.;Osman, Farzana;Mindel, Adrian
通讯作者：
Mindel, Adrian
影响因子：
2.9
作者：
Brooks, J. Paul;Edwards, David J.;Jefferson, Kimberly K.
通讯作者：
Jefferson, Kimberly K.
影响因子：
4.2
作者：
Breshears LM;Edwards VL;Ravel J;Peterson ML
通讯作者：
Peterson ML
影响因子：
21.1
作者：
Bautista CT;Wurapa E;Sateren WB;Morris S;Hollingsworth B;Sanchez JL
通讯作者：
Sanchez JL