Abstract
Study Objective
One concern regarding long-acting reversible contraceptive (LARC) use among female
adolescents is the potential for sexually transmitted infection acquisition. Few studies
investigate chlamydia infection among adolescent LARC users compared with other hormonal
contraceptive method (non-LARC) users. We hypothesized that incident chlamydia infection
would be similar in these 2 groups and that it would not be associated with adolescent
LARC use.
Design, Setting, and Participants
Secondary data analysis of electronic health records of adolescents who started using
LARC (n = 152) and non-LARC methods (n = 297) at 6 New York City school-based health
centers between March 2015 and March 2017.
Interventions and Main Outcome Measures
Demographic characteristics, sexual risk factors, and occurrence of chlamydia infection
over a period of 1 year were compared in the 2 groups using χ2 tests and t tests. Multivariable logistic regression was used to test the association between
LARC use and chlamydia infection adjusting for relevant covariates.
Results
Among 422 adolescent patients tested the year after method initiation, 48 (11.4%)
had at least 1 positive chlamydia test. The proportions of LARC users and non-LARC
users with chlamydia infection were not statistically significantly different (10.9%
vs 11.6%; P = .82). Multivariable analysis showed that LARC use was not associated with greater
chlamydia risk (adjusted odds ratio, 0.84; 95% confidence interval, 0.41-1.43).
Conclusion
Adolescent LARC users did not have significantly higher chlamydia infection occurrence
compared with non-LARC users the year after method initiation. Concern for chlamydial
infection should prompt recommending condom use but should not be a barrier to recommending
adolescent LARC use.
Key Words
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Article info
Publication history
Published online: September 19, 2019
Footnotes
The authors indicate no conflicts of interest.
These findings were presented, in part, at the 2018 Postdoc Research Symposium, Columbia University Irving Medical Center, New York, New York, December 4, 2018, and at the 2019 Society of Teachers for Family Medicine Annual Spring Conference, Toronto, Ontario, Canada, April 28, 2019.
Identification
Copyright
© 2020 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
