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Sexually Transmitted Infections and Contraceptive Use in Adolescents
Karen J Derefinko1, Sydney Ashby2, Tristan Hayes1
1Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
American Journal of Preventive Medicine
|February 22, 2020
Summary
Long-acting reversible contraceptives (LARCs) are safe for adolescents and do not increase sexually transmitted infection (STI) risk. LARCs, like hormonal implants, are associated with lower STI risk compared to birth control pills.
Area of Science:
- Reproductive Health
- Adolescent Medicine
- Infectious Disease Prevention
Background:
- Long-acting reversible contraceptives (LARCs) are recommended for female adolescents due to low failure rates.
- Concerns exist regarding potential decreases in condom use and increased sexually transmitted infection (STI) risk with LARC uptake.
- Limited research directly addresses the relationship between LARC use and STI diagnosis in adolescents.
Purpose of the Study:
- To compare the incidence of sexually transmitted infections (STIs) among female adolescents using different contraceptive methods.
- To investigate the association between LARC use versus other contraceptive methods and STI diagnosis.
Main Methods:
- Archival data analysis of Medicaid claims for female adolescents aged 14-19 years.
- Included 62,550 adolescents with contraceptive prescriptions and 1 year of follow-up data (2011-2015).
- Incidence of STIs was the primary outcome, with data analyzed in 2018.
Main Results:
- Hormonal implants (LARCs) showed a significantly lower risk of STIs compared to contraceptive pills (HR=0.81; 95% CI=0.70-0.93).
- Hormonal injections were associated with a higher risk of STIs than contraceptive pills (HR=1.08; 95% CI=1.00-1.16).
Conclusions:
- The risk of acquiring STIs is not higher with LARCs compared to other contraceptive methods.
- Findings support the use of LARCs in female adolescents, aligning with recommendations from major medical organizations.
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