GynecologyHormonal contraception and risk of sexually transmitted disease acquisition: Results from a prospective study☆,☆☆,★
Section snippets
Study procedures
In February 1993, an open cohort of female sex workers was established as part of the Preparation for AIDS Vaccine Evaluation/HIV Network for Prevention Trials initiative of the US National Institutes of Health. The study protocol was approved by the institutional review boards of the University of Washington and the University of Nairobi. Participants provided informed consent.
Clinical and laboratory procedures have been described previously.9 Briefly, registered prostitutes were offered
Study population characteristics
Between February 1993 and August 1999, 4528 women were screened for antibodies to HIV-1, and 2413 (53%) were seropositive. Among the 2115 seronegative women, 1202 (57%) were enrolled in the cohort. Nine hundred and ninety-four women (83% of those enrolled) returned for at least one follow-up visit, and 948 (95% of those with follow-up) met the inclusion criteria for this analysis. The median length of follow-up time was 421 days (range, 15-2366 days), and the median number of follow-up visits
Discussion
In this population of Kenyan prostitutes, oral contraceptive pill and DMPA use were both associated with significantly elevated risk of cervical chlamydial infection and significantly decreased risk of bacterial vaginosis, after controlling for sexual behavior and demographic factors. In addition, oral contraceptive use was associated with significantly increased risk of vaginal candidiasis, and DMPA use was associated with significantly decreased risk of trichomoniasis and PID. To our
Acknowledgements
We would like to acknowledge the dedication of the clinic and laboratory staff and the support of the Municipal Council of Mombasa and the administration of Coast Provincial General Hospital for use of their facilities. We are grateful to the women of Ganjoni Clinic, whose participation made this study possible.
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†Deceased.
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Supported in part by US National Institutes of Health grants AI33873, D43-TW00007, and T22-TW00001 and by Family Health International (subcontract NO1-A1-35173-119).
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Reprint requests: Jared M. Baeten, University of Washington, 325 Ninth Avenue, Box 359909, Seattle, WA 98104-2499. E-mail: [email protected].