Hormonal contraceptives and the acquisition of sexually transmitted infections: an updated systematic review.

McCarthy, Katharine J, Gollub, Erica L, Ralph, Lauren, van de Wijgert, Janneke ORCID: 0000-0003-2728-4560 and Jones, Heidi E (2019) Hormonal contraceptives and the acquisition of sexually transmitted infections: an updated systematic review. Sexually transmitted diseases, 46 (5). pp. 290-296.

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Abstract

BACKGROUND:Evidence suggests that some forms of hormonal contraception (HC) increase women's risk of non-HIV sexually transmitted infections (STIs), yet evidence has not been reviewed since 2008. We conducted an updated systematic review to incorporate studies published between January 2009 and June 2017 to examine the relationship between HCs and incident and/or recurrent STIs. METHODS:We searched PubMed and EMBASE to identify prospective studies comparing risk of Chlamydia trachomatis, Neisseria gonorrhoeae, human papillomavirus (HPV), herpes simplex virus type 2 (HSV-2), Treponema pallidum, or Trichomonas vaginalis, between women using HC vs. non-hormonal methods or no methods. We summarize results by type of STI and HC and study quality using an adapted Newcastle-Ottawa Quality Assessment Scale. RESULTS:Thirty articles met the inclusion criteria. Depo-medroxyprogesterone acetate (DMPA) reduces the risk of trichomoniasis (consistent evidence) and may increase the risk of HSV-2 (strong effect, few studies); inconclusive evidence exists for HPV, chlamydia, gonorrhea and syphilis. Data on oral contraceptive pills (OCPs; generally not differentiated whether combined or progestin-only pills) suggest use is associated with a reduced risk of trichomoniasis with inconclusive findings for HSV-2, HPV, chlamydia, gonorrhea, and syphilis. Very few studies included norethisterone enanthate (Net-En) injectable, implants or the levonorgestrel IUD. CONCLUSIONS:DMPA and OCPs reduce the risk of trichomoniasis and DMPA may increase the risk of HSV-2. However, the potential for confounding cannot be ruled out. Future studies should specify the type of injectable or OCP used to increase understanding of biological pathways; more research is needed on implants and hormonal IUDs.

Item Type:	Article
Uncontrolled Keywords:	Humans, Sexually Transmitted Diseases, Herpes Genitalis, Trichomonas Infections, Contraceptives, Oral, Hormonal, Risk, Risk Assessment, Prospective Studies, Female, Medroxyprogesterone Acetate
Depositing User:	Symplectic Admin
Date Deposited:	18 Jan 2019 10:11
Last Modified:	19 Jan 2023 01:06
DOI:	10.1097/olq.0000000000000975
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3031485