Combined Hormonal Contraception May Be Protective Against Neisseria gonorrhoeae Infection

• Published in: Sexually transmitted diseases 2010-06, Vol.37 (6), p.356-360
• Main Authors: Gursahaney, Priya R., Meyn, Leslie A., Hillier, Sharon L., Sweet, Richard L., Wiesenfeld, Harold C.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Bacterial diseases; Bacterial diseases of the genital system; Biological and medical sciences; Birth control; Contraceptive Agents, Female - administration & dosage; Contraceptives, Oral, Hormonal - administration & dosage; Female; General aspects; Gonorrhea; Gonorrhea - epidemiology; Gonorrhea - microbiology; Gonorrhea - prevention & control; Gonorrhea - transmission; Hormones; Human bacterial diseases; Human infectious diseases. Experimental studies and models; Humans; Infectious diseases; Interviews as Topic; Longitudinal Studies; Male; Medical sciences; Medroxyprogesterone Acetate - administration & dosage; Neisseria gonorrhoeae; Original Study; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sexual Behavior; Sexually transmitted diseases; STD; Treatment Outcome; Urethritis - epidemiology; Urethritis - microbiology; Urethritis - prevention & control; Uterine Cervicitis - microbiology; Uterine Cervicitis - prevention & control; Womens health; Young Adult
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/OLQ.0b013e3181d40ff1

Background: The role of hormonal contraception on acquisition of gonorrhea has not been well-characterized, as the transmission dynamics of Neisseria gonorrhoeae are poorly understood. The purpose of this study is to determine the influence of hormonal contraception on gonococcal infection in women exposed to males with gonococcal urethritis. Methods: Females aged 15 to 35 years reporting sexual contact to a male partner diagnosed with N. gonorrhoeae were enrolled. Demographic and sexual histories, physical findings, and laboratory tests were collected. Women testing positive and negative for cervical N. gonorrhoeae were compared using χ² and Fisher exact tests, with multivariable logistic regression performed on those factors independently associated with gonococcal infection on univariate analysis. Results: N. gonorrhoeae infection occurred in 68 of 107 (64%) women. Women using combined hormonal contraception were significantly less likely than nonusers to test positive for N. gonorrhoeae (32% vs. 76%; prevalence ratio: 0.42; 95% confidence interval: 0.22, 0.78; P = 0.006). Gonorrhea was also less common in depomedroxyprogesterone acetate users. A new sexual partner was also associated with testing positive for gonorrhea (35% vs. 13%; prevalence ratio: 1.47; 95% confidence interval: 1.13, 1.90; P = 0.004). Conclusions: Women using combined hormonal contraceptives or depomedroxyprogesterone acetate were less likely to test positive for N. gonorrhoeae after sexual exposure compared with nonusers. Our data suggest that, in addition to contraceptive benefits, modern hormonal contraception may have a protective effect on the acquisition of N. gonorrhoeae.