Hormonal contraception and risk of bacterial vaginosis diagnosis in an observational study of women attending STD clinics in Baltimore, MD
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.
Conclusion
Hormonal contraception was associated with a decreased risk of BV in an STD clinic cohort.
aDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
bBaltimore City Health Department, Baltimore, MD 21205, USA
cDivision of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
dInstitute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, 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.
ABSTRACT