2020
DOI: 10.1136/sextrans-2020-054483
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Hormonal contraception and risk of STIs and bacterial vaginosis in South African adolescents: secondary analysis of a randomised trial

Abstract: ObjectivesYoung women in sub-Saharan Africa are at high risk of STIs and unintended pregnancies, yet hormonal contraceptive (HC) use may affect STI risk. We compared the influence of three HCs on the incidence and prevalence of STIs and bacterial vaginosis (BV) in South African adolescents.MethodsOne hundred and thirty adolescents between 15 and 19 years were randomised to the injectable norethisterone enanthate (Net-En), combined oral contraceptives (COC) (Triphasil or Nordette) or a combined contraceptive va… Show more

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Cited by 7 publications
(14 citation statements)
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“…At this visit, the participants in the three study arms did not significantly differ in BV (by Nugent score), Candida , or overall STI prevalence, HSV-2 serology, antibiotic use, or sexual risk behavior ( Supplementary Table 7 ). However, as described previously, the prevalence of N. gonorrheae was higher among CCVR users, and adolescents assigned to COC had more optimal bacterial communities and adolescents assigned to CCVR generally had higher levels of inflammatory cytokines ( Supplementary Table 7 ) ( 9 , 40 ).…”
Section: Resultssupporting
confidence: 64%
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“…At this visit, the participants in the three study arms did not significantly differ in BV (by Nugent score), Candida , or overall STI prevalence, HSV-2 serology, antibiotic use, or sexual risk behavior ( Supplementary Table 7 ). However, as described previously, the prevalence of N. gonorrheae was higher among CCVR users, and adolescents assigned to COC had more optimal bacterial communities and adolescents assigned to CCVR generally had higher levels of inflammatory cytokines ( Supplementary Table 7 ) ( 9 , 40 ).…”
Section: Resultssupporting
confidence: 64%
“…One hundred and eighty adolescent females were screened for the parent study (NCT02404038) (41), and 130 were enrolled (Supplementary 7). However, as described previously, the prevalence of N. gonorrheae was higher among CCVR users, and adolescents assigned to COC had more optimal bacterial communities and adolescents assigned to CCVR generally had higher levels of inflammatory cytokines (Supplementary Table 7) (9,40).…”
Section: Cohort Characteristicssupporting
confidence: 63%
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“…80 Furthermore, the incidence of any bacterial STI was found to be higher in adolescents using ETG/EE IVR compared to those using NET-EN or OCP. 80 Given the possible relationship between STI susceptibility and the vaginal microbiota, these findings require further investigation.…”
Section: Randomized Datamentioning
confidence: 99%
“…62 Nonetheless, as described previously, mechanistic studies suggest that certain contraceptives impact FGT biology in ways that are likely relevant to sexual and reproductive health, although possibly of insufficient magnitude and/or duration to impact HIV acquisition. 57,63,64 Continued research to understand these biological effects are important for the development of novel contraceptives and multipurpose prevention products (MPTs) that concurrently protect from pregnancy, STIs and HIV.…”
Section: Findings From the Echo Trialmentioning
confidence: 99%