Open access journal of contraception最新文献

{"title":"Unmet Need for Contraception Among Young Married Women in Eastern Ethiopia.","authors":"Tariku Dingeta,&nbsp;Lemessa Oljira,&nbsp;Alemayehu Worku,&nbsp;Yemane Berhane","doi":"10.2147/OAJC.S227260","DOIUrl":"https://doi.org/10.2147/OAJC.S227260","url":null,"abstract":"<p><strong>Purpose: </strong>Addressing the contraceptive needs of young married women is critical to improve their health and well-being. In patriarchal societies, young married women are under intense pressure to demonstrate their fecundity. Therefore, research that specifically address the needs for contraception of young married women have been generally given less emphasis in Ethiopia. This study assessed the extent of unmet needs for contraception and its associated factors among young married women in Eastern Ethiopia.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted among young married women (14-24 years of age) in Eastern Ethiopia. Data were collected using a structured questionnaire. The prevalence ratio (PR) with 95% confidence intervals (CIs) was calculated, and factors associated with unmet needs for contraception were identified using log-binomial regression statistical model.</p><p><strong>Results: </strong>Among 2933 young women interviewed, the unmet need for contraception was 1014 (34.6%; 95% CI, 32.9%-36.4%). The prevalence of unmet needs for contraception decreased with increased young women's household decision-making autonomy score (APR= 0. 76; CI=0.62-0.94). Exposure to family planning (FP) information during the last 12 months (APR= 1.24; CI=1.1-1.42), age 18 or more years (APR=1.25; CI=1.04-1.5), multiparty (APR= 1. 9; CI=1.7-2.1) and desire to have 5 children or lesser than 5 children (APR= 1. 2; CI=1.06-1.32) were associated with higher prevalence of unmet needs for contraception.</p><p><strong>Conclusion: </strong>One-third of married young women had unmet needs for contraception. More efforts to empower women to make decisions that affect their own life and providing appropriate family planning information are necessary to reduce the burden of unmet needs among young married women in rural settings in Ethiopia.</p>","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S227260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37518842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Women In Lomé Getting Their Desired Methods Of Contraception? Understanding Provider Bias From Restrictions To Choice.","authors":"Elizabeth Pleasants,&nbsp;Tekou B Koffi,&nbsp;Karen Weidert,&nbsp;Sandra I McCoy,&nbsp;Ndola Prata","doi":"10.2147/OAJC.S226481","DOIUrl":"https://doi.org/10.2147/OAJC.S226481","url":null,"abstract":"<p><strong>Background: </strong>Despite improvements in contraception availability, women face persistent barriers that compromise reproductive autonomy and informed choice. Provider bias is one way in which access to contraception can be restricted within clinical encounters and has been established as common in sub-Saharan Africa. This analysis assessed the prevalence of provider restrictions and the potential impact on women's method uptake in Lomé, Togo.</p><p><strong>Methods: </strong>This sub-analysis used survey data from provider and client interviews collected to assess the impacts of the Agir pour la Planification Familiale (AgirPF) program in Togo. The relationships between provider restrictiveness and women's receipt of their desired method of contraception were modelled using mixed effects logistic regressions looking at all women and among subgroups hypothesized to be at potentially higher risk of bias.</p><p><strong>Results: </strong>Around 84% of providers reported a restriction in contraceptive provision for the five contraceptive methods explored (pill, male condom, injectable, IUD, and implant). Around 53% of providers reported restricting at least four of the five methods based on age, parity, partner consent, or marital status. Among all women, there were no significant associations between provider restrictiveness and women's receipt of desired method, including among those who desired long-acting methods. In adjusted modeling, marital status was a covariate significantly associated with desired method, with married women more likely to receive their desired method than unmarried women (aOR 2.73, 95% CI 1.45-5.13).</p><p><strong>Conclusion: </strong>Provider reports of high levels of restrictions in this population are concerning and should be further explored, especially its effects on unmarried women. However, restrictions reported by providers in this study did not appear to statistically significantly influence contraceptive method received.</p>","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S226481","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37448931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception And Use Of Intrauterine Contraceptive Devices (IUCD) Among Married Women Of Reproductive Age In Bhaktapur, Nepal","authors":"Bijay Khatri, A. Khadka, A. Amatya, S. Shrestha, R. Paudel","doi":"10.2147/OAJC.S219188","DOIUrl":"https://doi.org/10.2147/OAJC.S219188","url":null,"abstract":"Purpose The copper-T (TCu-380A), an intrauterine contraceptive device (IUCD), is widely available and is highly effective in terms of safety and effectiveness. Despite this fact, there is low utilization of IUCD in Nepal. This paper describes the perception and use of IUCD among married women of reproductive age attending an institutional clinic in Bhaktapur, Nepal. Methods An institution-based cross-sectional study was conducted among 273 married women attending the institutional clinic of Bhaktapur hospital who were interviewed by trained staff nurses using semi-structured questionnaires. Systematic random sampling method was applied to select the participants. Logistic regression analysis was used to determine the relationship between factors associated with utilization of IUCD. Results Just below half (48.7%) of the participants had heard about IUCD. Only 7.0% of the potential users were currently using IUCD, and all of them had discussed using it with their husbands. Among women aware of IUCD, nearly a quarter of them (23.8%) did not want to use it because of their husband’s disapproval and their assumed fear of decreased sexual pleasure. There was a significant association between previous abortion and use of IUCD, where the women who had a history of abortion had increased odds of using the IUCD by 5.45-times compared to those who had not (p=0.01). The women who were counseled about IUCD by health workers were 2.83-times more likely to use an IUCD than those who were not. The women who had a good knowledge level about IUCD as a method of modern contraception had 2.85-times increased odds of using the IUCD compared to those who had poor or no knowledge about it. Conclusion The use of IUCD depends on the support of husbands, knowledge about its safety, efficacy, and counseling.","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S219188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41486315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Voluntary, Rights-Based Family Planning: Experience From Nigeria And Uganda","authors":"K. Hardee, Kaja Jurczynska, I. Sinai, Victoria Boydell, Diana Kabahuma Muhwezi, K. Gray, K. Wright","doi":"10.2147/OAJC.S215945","DOIUrl":"https://doi.org/10.2147/OAJC.S215945","url":null,"abstract":"Background Growing focus on the need for voluntary, rights-based family planning (VRBFP) has drawn attention to the lack of programs that adhere to the range of rights principles. This paper describes two first-of-their-kind interventions in Kaduna State, Nigeria and in Uganda in 2016–2017, accompanied by implementation research based on a conceptual framework that translates internationally agreed rights into family planning programming. Methods This paper describes the interventions, and profiles lessons learned about VRBFP implementation from both countries, as well as measured outcomes of VRBFP programming from Nigeria. Results The intervention components in both projects were similar. Both programs built provider and supervisor capacity in VRBFP using comparable curricula; developed facility-level action plans and supported action plan implementation; aimed to increase clients’ rights literacy at the facility using posters and handouts; and established or strengthened health committee structures to support VRBFP. Through the interventions, rights literacy increased, and providers were able to see the benefits of taking a VRBFP approach to serving clients. The importance of ensuring a client focus and supporting clients to make their own family planning choices was reinforced. Providers recognized the importance of treating all clients, regardless of age or marital status, for example, with dignity. Privacy and confidentiality were enhanced. Recognition of what violations of rights are and the need to report and address them through strong accountability systems grew. Many lessons were shared across the two countries, including the need for rights literacy; attention to health systems issues; strong and supportive supervision; and the importance of working at multiple levels. Additionally, some unique lessons emanated from each country experience. Conclusion The assessed feasibility and benefits of using VRBFP programming and outcome measures in both countries bode well for adoption of this approach in other geographies.","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S215945","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46622065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive Options Following Gestational Diabetes: Current Perspectives","authors":"A. Turner, Emily A. Donelan, Jessica W. Kiley","doi":"10.2147/OAJC.S184821","DOIUrl":"https://doi.org/10.2147/OAJC.S184821","url":null,"abstract":"Abstract Gestational diabetes mellitus (GDM) complicates approximately 7% of pregnancies in the United States. Along with risk factors related to pregnancy, women with a history of GDM also have an increased risk of developing type 2 diabetes mellitus later in life. These women require special consideration when discussing contraception and other reproductive health issues. GDM carries a category 1 rating in the US Medical Eligibility Criteria for all contraceptive methods, which supports safety of the various methods but does not account for effectiveness. Contraceptive options differ in composition and mechanisms of action, and concerns have been raised about possible effects of contraception on metabolism. Clinical evidence is limited to suggest that hormonal contraception has significantly adverse effects on body weight, lipid, or glucose metabolism. In addition, the majority of evidence does not suggest a relationship between development of type 2 diabetes mellitus and use of hormonal contraception. Data are limited, so it is challenging to make a broad, general recommendation regarding contraception for women with a history of GDM. A woman’s history of GDM should be considered during contraceptive counseling. Discussion should focus on potential medical comorbidities and the implications of GDM on future health, with special consideration of issues including bone health, obesity, cardiovascular disease, and thrombosis risk. Providers must emphasize the importance of reliable, highly effective contraception for women with GDM, to optimize the timing of future pregnancies. This approach to comprehensive counseling will guide optimal decision-making on contraceptive use, lifestyle changes, and planning of subsequent pregnancies.","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S184821","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45808121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum Contraceptive Use In Parakou (A City In Northern Benin) In 2018: A Community Based Cross-Sectional Study","authors":"F. Hounkponou, Yolaine Glèlè Ahanhanzo, C. Biaou, Candide Russel Dos-Santos, A. Ahouingnan, A. A. Obossou, Rachidi Sidi Imorou, M. Vodouhè, H. Laourou, K. Salifou, R. Perrin","doi":"10.2147/OAJC.S219709","DOIUrl":"https://doi.org/10.2147/OAJC.S219709","url":null,"abstract":"Background Over 30% of maternal deaths and 10% of infant deaths are avoidable if couples space out births at intervals of 2 years or greater. This study aimed to identify factors associated with contraceptive use in the postpartum period. Methods This was a cross-sectional study among postpartum women living in Parakou. Participants were selected using a two-stage sampling method. Postpartum contraceptive use was defined as the use of at least one contraceptive method at the time of the survey. Independent variables included socio demographic and reproductive history. For the analysis we performed a multiple logistic regression and we calculated odds ratios with 95% confidence intervals. Results The study included 453 postpartum women. Among the participants, 59 (13%) were using a contraceptive method. Injectable contraceptives were the most common method used (25.4%). Factors associated with contraceptive use in the postpartum period included history of contraceptive use (AOR=9.4; p<0.001), resumption of sexual intercourse (AOR=5.7; p<0.001), discussion with partner about contraceptive method (AOR=5.7; p=0.005), need of partner’s approval before adopting a contraceptive method (AOR=0.4; p=0.014) and counseling during pregnancy, in the delivery room, and during postnatal visits (AOR=2.7; p=0.019). Conclusion The prevalence of contraceptive use during the postpartum period remains low. Interventions should be designed with a focus on the associated factors in order to increase postpartum contraceptive use in Parakou.","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S219709","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49130023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraception counseling for women with premenstrual dysphoric disorder (PMDD): current perspectives","authors":"Andrea J. Rapkin, Yelena Korotkaya, Kathrine C Taylor","doi":"10.2147/OAJC.S183193","DOIUrl":"https://doi.org/10.2147/OAJC.S183193","url":null,"abstract":"Abstract Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS) affecting up to 7% of reproductive age women. Women with PMDD are of reproductive age; therefore, contraception and treatment of PMDD are important considerations. The disorder as described in the DSM-V is characterized by moderate to severe psychological, behavioral and physical symptoms beginning up to two weeks prior to menses, resolving soon after the onset of menstruation and significantly interfering with daily functioning. PMDD develops in predisposed individuals after they are exposed to progesterone at the time of ovulation. It has been hypothesized that PMDD is in part attributable to luteal phase abnormalities in serotonergic activity and to altered configuration of ℽ-aminobutyric acid subunit A (GABAA) receptors in the brain triggered by the exposure to the neuroactive steroid progesterone metabolite, allopregnanolone (Allo). A large body of evidence suggests that selective serotonin reuptake inhibitors (SSRIs) can be effective in the treatment of PMDD. Combined hormonal contraceptive (CHC) pills, specifically the 20 mcg ethinyl estradiol/3mg drospirenone in a 24/4 extended cycle regimen has been shown to significantly improve the emotional and physical symptoms of PMDD. Other combined monophasic, extended cycle hormonal contraceptive pills with less androgenic progestins may also be helpful, although not well studied. Copper intrauterine devices (IUDs) are recommended for those not seeking hormonal contraceptives. Progestin-only methods including the progestin-only pill (POP), levonorgestrel (LNG) IUD, etonorgestrel implant or depot medroxyprogesterone acetate (DMPA) have the potential to negatively affect mood symptoms for women with or without baseline mood disorders, including PMDD. Careful counseling and close follow-up is recommended for patients with PMDD seeking these contraceptive methods.","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S183193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43113097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"When you least expect, this happens, it's already growing\": Problematizing the definition of unmet need for family planning.","authors":"Ielaf Khalil,&nbsp;Emma Zl Richardson","doi":"10.2147/OAJC.S184909","DOIUrl":"https://doi.org/10.2147/OAJC.S184909","url":null,"abstract":"<p><p><b>Background:</b> Unmet need is an important indicator to understand baselines and set goals for family planning interventions. Women may not fall neatly in categories of met or unmet need for family planning as defined by the demographic and health surveys (DHS). We explore women's experiences of unmet need for family planning and provide empirical examples of how the static, binary DHS definitions of met and unmet need for family planning may be problematic. <b>Methods:</b> Based on Social Cognitive Theory, we conducted elicitation interviews with 16 married young women between the ages of 20 and 24 in Chimaltenango, Guatemala to explore barriers to accessing and using family planning. Half the participants (n=8) were using a modern method of family planning and half (n=8) were not. The current analysis focuses on data that was coded as ambiguous or unclear for unmet need status. <b>Results:</b> We identified framings of ambiguity from the women's narratives that are silenced by the dominant binary of met and unmet need. We show inconsistencies between women's lived experiences of unmet need and how their experiences would likely be represented in DHS questionnaires: 1) successful use of natural methods; 2) the complexity of \"wantedness\"; 3) conceptualizing met or unmet need as a trajectory; and 4) laughter obscuring clear response. <b>Conclusion:</b> Family planning status is a complex trajectory that the DHS may not accurately capture. As a way to reflect the diversity of women's family planning experiences, we suggest modifying the DHS classifications to incorporate latent met and unmet need as sub-classifications.</p>","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S184909","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37344013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraception with estradiol valerate and dienogest: adherence to the method.","authors":"Franca Fruzzetti,&nbsp;Anna Maria Paoletti,&nbsp;Tiziana Fidecicchi,&nbsp;Giulia Posar,&nbsp;Riccardo Giannini,&nbsp;Marco Gambacciani","doi":"10.2147/OAJC.S204655","DOIUrl":"https://doi.org/10.2147/OAJC.S204655","url":null,"abstract":"<p><p><b>Purpose:</b> The aim of the study was to examine the discontinuation rate of hormonal contraception with estradiol valerate (E2V) and dienogest (DNG). <b>Patients and methods:</b> We collected data at the Family Planning Clinics of the Departments of Obstetrics and Gynecology of Pisa and Cagliari. We included in the analysis 354 consecutive women using oral contraceptive pills containing E2V and DNG. We analyzed the rate and the reason for discontinuation, classifying the reasons in 5 categories: 1) minor side effects, 2) adverse events, 3) other events not directly caused by the drug or conditions for which the pill could represent a risk factor, 4) no compliance with the method and 5) no further need. <b>Results:</b> Of the 354 women examined, 50.8% had discontinued E2V/DNG pill. Excluding women who stopped the pill because of no further need (10.5%), 27.4% discontinued because of minor side effects, 1.7% discontinued for adverse events, 9.9% because of other events not directly caused by the drug or conditions for which the pill could represent a risk factor and 1.4% because of difficulties with compliance. Irregular bleedings were the main reasons reported for discontinuation. The time to discontinuation for irregular bleedings was significantly (<i>p</i><0.02) longer in adults than in adolescents and slightly but not significantly longer in women who received information about this possible effect. <b>Conclusion:</b> Unacceptable cycle control was the principal cause of discontinuation of pill with E2V and DNG. An appropriate information about this possible effect may improve adherence to this combined oral contraceptive.</p>","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S204655","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37324531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive use and the risk of sexually transmitted infection: systematic review and current perspectives.","authors":"Jennifer Deese,&nbsp;Subarna Pradhan,&nbsp;Hannah Goetz,&nbsp;Charles Morrison","doi":"10.2147/OAJC.S135439","DOIUrl":"https://doi.org/10.2147/OAJC.S135439","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence on the association between contraceptive use and risk of sexually transmitted infections (STIs) and bacterial vaginosis (BV) is lacking, with few prospective studies. We systematically reviewed the last 10 years' evidence on the association between contraception and STI/BV, building on the most recent systematic reviews published in 2006 and 2009.</p><p><strong>Methods: </strong>We searched the MEDLINE and POPLINE databases for peer-reviewed articles p ublished between January 1, 2008 and January 31, 2018 reporting prospective studies that assessed the association between contraceptive use and incident STI and/or incident or recurrent BV.</p><p><strong>Results: </strong>We identified 33 articles that evaluated combined oral contraceptives (COC), depot medroxyprogesterone acetate (DMPA), the copper intrauterine device (Cu-IUD), the levonorgestrel intrauterine system (LNG-IUS) and other methods. The strength of the evidence for many specific contraceptive method/STI associations is limited by few prospective studies with comparably defined exposures and outcomes. Available data suggest no association of COCs and <i>Neisseria gonorrhoeae</i>, <i>Trichomonas vaginalis</i>, HSV-2 or syphilis, and mixed evidence on the association with HPV, <i>Chlamydia trachomatis</i>, and BV. For DMPA, none of the studies identified found an association with <i>N. gonorrhoeae</i> or syphilis, and data on <i>C. trachomatis, T. vaginalis,</i> HPV and BV were mixed. Two large studies showed a highly clinically significant increased risk of HSV-2 infection with DMPA use. Data on the effect of Cu-IUD and the LNG-IUS on the acquisition of <i>C. trachomatis</i>, <i>N. gonorrhoeae</i> and <i>T. vaginali</i>s are sparse, and data on HPV and BV are mixed.</p><p><strong>Conclusion: </strong>Few data are available from prospective studies, including randomized trials, to draw strong conclusions about the relationships between contraceptive methods and specific STIs. The overall evidence on the association between contraceptive use and STI/BV risk is limited by the lack of any randomized trials, few published prospective studies designed to analyze these associations, wide variability in exposure definitions and comparator groups, potential for confounding due to inaccurate sexual behavior data, differential confounder adjustment and differences in study populations and sizes. Despite these limitations, new evidence is supportive of a significantly increased risk of HSV-2 infection among DMPA users which warrants additional research to better understand this association.</p>","PeriodicalId":74348,"journal":{"name":"Open access journal of contraception","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OAJC.S135439","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36799528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}