Hormonal contraception and risk of bacterial vaginosis diagnosis in an observational study of women attending STD clinics in Baltimore, MD

Rifkin, Samara B.; Smith, Marsha R.; Brotman, Rebecca M.; Gindi, Renee M.; Erbelding, Emily J.

doi:10.1016/j.contraception.2009.01.008

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Volume 80, Issue 1 , Pages 63-67, July 2009

Hormonal contraception and risk of bacterial vaginosis diagnosis in an observational study of women attending STD clinics in Baltimore, MD

Samara B. Rifkin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
Marsha R. Smith
- Baltimore City Health Department, Baltimore, MD 21205, USA
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
Rebecca M. Brotman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
Renee M. Gindi
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
Emily J. Erbelding
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Baltimore City Health Department, Baltimore, MD 21205, USA
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Corresponding author. Division of Infectious Diseases, Johns Hopkins Bayview Medical Center, Mason F Lord Center Tower, Baltimore, MD 21224, USA. Tel.: +1 410 550 6254; fax: +1 410 550 2328.

Received 20 October 2008; received in revised form 15 January 2009; accepted 15 January 2009. published online 05 March 2009.

Abstract

Background

The protective effect of hormonal contraception may offer a potential intervention against bacterial vaginosis (BV).

Study Design

Three hundred thirty reproductive-age women enrolled in a contraceptive program from April 2005 to October 2006 at two sexually transmitted diseases clinics in Baltimore, MD. Participants were supplied with hormonal contraceptives of their choice and followed prospectively. BV was diagnosed by Amsel's criteria. Results from population-level analysis were compared to a case-crossover analysis.

Results

BV was diagnosed in 189 (13.0%) of the visits among 133 (40.3%) women. In the population-level analysis, the use of progestin-only and combined contraception was associated with a decreased risk of BV compared to intervals of no hormonal contraceptive use [adjusted odds ratio (AOR): 0.42 (95% CI: 0.20–0.88) and AOR: 0.66 (95% CI: 0.39–1.10), respectively]. The case-crossover analysis demonstrated a similar trend in findings.