PT - JOURNAL ARTICLE AU - Jennifer Deese AU - Neena Philip AU - Margaret Lind AU - Khatija Ahmed AU - Joanne Batting AU - Mags Beksinska AU - Vinodh A Edward AU - Cheryl E Louw AU - Maricianah Onono AU - Thesla Palanee-Phillips AU - Jennifer A Smit AU - Jared M Baeten AU - Deborah Donnell AU - Timothy D Mastro AU - Nelly R Mugo AU - Kavita Nanda AU - Helen Rees AU - Charles Morrison TI - Sexually transmitted infections among women randomised to depot medroxyprogesterone acetate, a copper intrauterine device or a levonorgestrel implant AID - 10.1136/sextrans-2020-054590 DP - 2021 Jun 01 TA - Sexually Transmitted Infections PG - 249--255 VI - 97 IP - 4 4099 - http://sti.bmj.com/content/97/4/249.short 4100 - http://sti.bmj.com/content/97/4/249.full SO - Sex Transm Infect2021 Jun 01; 97 AB - Objectives Reproductive aged women are at risk of pregnancy and sexually transmitted infections (STI). Understanding drivers of STI acquisition, including any association with widely used contraceptives, could help us to reduce STI prevalence and comorbidities. We compared the risk of STI among women randomised to three contraceptive methods.Methods We conducted a secondary analysis to assess the risk of chlamydia and gonorrhoea in a clinical trial evaluating HIV risk among 7829 women aged 16–35 randomised to intramuscular depot medroxyprogesterone acetate (DMPA-IM), a copper intrauterine device (IUD) or a levonorgestrel (LNG) implant. We estimated chlamydia and gonorrhoea prevalences by contraceptive group and prevalence ratios (PR) using log-binomial regression.Results At baseline, chlamydia and gonorrhoea prevalences were 18% and 5%, respectively. Final visit chlamydia prevalence did not differ significantly between DMPA-IM and copper IUD groups or between copper IUD and LNG implant groups. The DMPA-IM group had significantly lower risk of chlamydia compared with the LNG implant group (PR 0.83, 95% CI 0.72 to 0.95). Final visit gonorrhoea prevalence differed significantly only between the DMPA-IM and the copper IUD groups (PR 0.67, 95% CI 0.52 to 0.87).Conclusions The findings suggest that chlamydia and gonorrhoea risk may vary with contraceptive method use. Further investigation is warranted to better understand the mechanisms of chlamydia and gonorrhoea susceptibility in the context of contraceptive use.Data are available on reasonable request. As of the time of publication, data access applications are in process with the governing IRBs of the ECHO trial to make de-identified publicly available.