Depot medroxyprogesterone acetate use is not associated with risk of incident sexually transmitted infections among adolescent women

Amy Romer, Marcia Shew, Susan Ofner, Melissa L. Gilliam, Summer L. Martins, J. Fortenberry

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: To determine whether depot medroxyprogesterone acetate (DMPA) use is associated with an increased risk of acquisition of sexually transmitted infections (STIs) in a cohort of healthy adolescents, for whom prospective evidence is sparse. Methods: Adolescent women aged 14-17 years (n = 342) were recruited from clinical sites in the United States between 1999 and 2005. They returned quarterly for interviews and STI testing. During alternating 3-month periods, participants also completed daily diaries of sexual behaviors and performed weekly vaginal self-obtained swabs to test for STIs. Data collected through 2009 (median follow-up length = 42.2 months) were analyzed. Univariable and multivariable tests of association between STI acquisition during the 3-month diary period and covariates were calculated, using nonlinear mixed-effect logistic regression models to control for repeated measurements. Results: In multivariable analysis, there were no significant associations between DMPA use in the current or previous 3-month period and incidence of Chlamydia trachomatis, Neisseria gonorrhoeae, or Trichomonas vaginalis. The number of total or unprotected sexual events during the diary period was not associated with the risk of STI. Older age was a protective factor for the development of Chlamydia trachomatis (odds ratio =.85; 95% confidence interval =.76-.96). The only factor significantly associated with an increased risk of contracting all three STIs was a greater number of sexual partners during the diary period (odds ratio, range = 1.91-2.62). Conclusions: In this U.S.-based cohort of adolescent women, we found no evidence that DMPA use was associated with increased STI risk. Efforts to curb STI transmission among adolescents should focus on education about the reduced number of sexual partners.

Original languageEnglish
Pages (from-to)83-88
Number of pages6
JournalJournal of Adolescent Health
Volume52
Issue number1
DOIs
StatePublished - Jan 2013

Fingerprint

Medroxyprogesterone Acetate
Sexually Transmitted Diseases
Sexual Partners
Chlamydia trachomatis
Logistic Models
Odds Ratio
Trichomonas vaginalis
Infectious Disease Transmission
Neisseria gonorrhoeae
Sexual Behavior
Confidence Intervals
Interviews
Education
Incidence

Keywords

  • Adolescent
  • Medroxyprogesterone acetate
  • Prospective studies
  • Sexual behavior
  • Sexually transmitted diseases

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health
  • Public Health, Environmental and Occupational Health

Cite this

Depot medroxyprogesterone acetate use is not associated with risk of incident sexually transmitted infections among adolescent women. / Romer, Amy; Shew, Marcia; Ofner, Susan; Gilliam, Melissa L.; Martins, Summer L.; Fortenberry, J.

In: Journal of Adolescent Health, Vol. 52, No. 1, 01.2013, p. 83-88.

Research output: Contribution to journalArticle

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abstract = "Purpose: To determine whether depot medroxyprogesterone acetate (DMPA) use is associated with an increased risk of acquisition of sexually transmitted infections (STIs) in a cohort of healthy adolescents, for whom prospective evidence is sparse. Methods: Adolescent women aged 14-17 years (n = 342) were recruited from clinical sites in the United States between 1999 and 2005. They returned quarterly for interviews and STI testing. During alternating 3-month periods, participants also completed daily diaries of sexual behaviors and performed weekly vaginal self-obtained swabs to test for STIs. Data collected through 2009 (median follow-up length = 42.2 months) were analyzed. Univariable and multivariable tests of association between STI acquisition during the 3-month diary period and covariates were calculated, using nonlinear mixed-effect logistic regression models to control for repeated measurements. Results: In multivariable analysis, there were no significant associations between DMPA use in the current or previous 3-month period and incidence of Chlamydia trachomatis, Neisseria gonorrhoeae, or Trichomonas vaginalis. The number of total or unprotected sexual events during the diary period was not associated with the risk of STI. Older age was a protective factor for the development of Chlamydia trachomatis (odds ratio =.85; 95{\%} confidence interval =.76-.96). The only factor significantly associated with an increased risk of contracting all three STIs was a greater number of sexual partners during the diary period (odds ratio, range = 1.91-2.62). Conclusions: In this U.S.-based cohort of adolescent women, we found no evidence that DMPA use was associated with increased STI risk. Efforts to curb STI transmission among adolescents should focus on education about the reduced number of sexual partners.",
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