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Chlamydia Infection Among Adolescent Long-Acting Reversible Contraceptive and Shorter-Acting Hormonal Contraceptive Users Receiving Services at New York City School-Based Health Centers

Published:September 19, 2019DOI:https://doi.org/10.1016/j.jpag.2019.09.006

      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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