Intrauterine Devices and Sexually Transmitted Infection among Older Adolescents and Young Adults in a Cluster Randomized Trial
| Autor: | El Ayadi, Alison M, Rocca, Corinne H, Averbach, Sarah H, Goodman, Suzan, Darney, Philip D, Patel, Ashlesha, Harper, Cynthia C |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Adolescent Clinical Trials and Supportive Activities Chlamydia trachomatis Reproductive health and childbirth Paediatrics and Reproductive Medicine Gonorrhea Young Adult Pregnancy Clinical Research Humans Intrauterine device Obstetrics & Reproductive Medicine Sexually transmitted diseases Pediatric Prevention Contraception/Reproduction Chlamydia Infections Neisseria gonorrhoeae Sexual Partners Contraception Good Health and Well Being Family Planning Services Sexually Transmitted Infections Female partners Infection Intrauterine Devices Adolescent Sexual Activity |
| Zdroj: | Journal of pediatric and adolescent gynecology, vol 34, iss 3 |
| Popis: | Study objectiveProvider 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.DesignSecondary analysis of a cluster-randomized provider educational trial.SettingForty US-based reproductive health centers.ParticipantsWe followed 1350 participants for 12months aged 18-25years who sought contraceptive care.InterventionsThe parent study assessed the effect of provider training on evidence-based contraceptive counseling.Main outcome measuresWe assessed incidence of GC/CT diagnoses according to IUD use and sexually transmitted infection risk factors using Cox regression modeling and generalized estimating equations.ResultsTwo 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).ConclusionIn 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|