Sexually Transmitted Infections and Contraceptive Use in Adolescents

Karen J. Derefinko, Sydney Ashby, Tristan Hayes, Cameron Kaplan, Zoran Bursac, Francisco I.Salgado García, Amy Madjlesi, Leah Tonkin, Michelle Bowden, Filoteia Popescu, Teresa Waters

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Introduction: Although a number of contraception methods exist, long-acting reversible contraceptives have been recommended for female adolescents owing to their low failure rates. However, concern exists that the increasing use of long-acting reversible contraceptive among female adolescents may have unintended consequences of decreasing condom use for the prevention of sexually transmitted infections. Despite this concern, few studies have directly explored the relationship between the use of long-acting reversible contraceptive versus other forms of contraception and diagnosis of sexually transmitted infections in female adolescents. This study compares the rates of sexually transmitted infection diagnosis following various forms of contraceptive use. Methods: This study was an archival data analysis of single state Medicaid claims retrieved for female adolescents, aged 14–19 years, who received a contraceptive prescription and had 1 year of follow-up data available (n=62,550) between 2011 and 2015. Incidence of sexually transmitted infections was the outcome of interest. Data analysis was conducted in 2018. Results: Compared with the contraceptive pill, hormonal implant (a form of long-acting reversible contraceptives) was associated with significantly lower risk of sexually transmitted infections (hazard ratio=0.81; 95% CI=0.70, 0.93; p=0.004), and hormonal injection was associated with higher risk of sexually transmitted infections (hazard ratio=1.08; 95% CI=1.00, 1.16; p=0.040). Conclusions: This analysis provides strong evidence that the risk for the acquisition of sexually transmitted infections is no higher for long-acting reversible contraceptives than for other forms of contraception. These results support the use of long-acting reversible contraceptive in female adolescents, as proposed and reaffirmed by the American College of Obstetricians and Gynecologists and American Academy of Pediatrics.

Original languageEnglish
Pages (from-to)536-546
Number of pages11
JournalAmerican Journal of Preventive Medicine
Issue number4
StatePublished - Apr 2020

Bibliographical note

Publisher Copyright:
© 2020 American Journal of Preventive Medicine

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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