Long-term, reversible contraception use among high-risk women treated in a university-based gynecology clinic: comparison between IUD and depo-provera.
BACKGROUND
The study was conducted to compare rates of sexually transmitted diseases (STD) and side effects in a cohort of high-risk women who received either an intrauterine device (IUD) or depo-medroxyprogesterone acetate (DMPA).


METHODS
We performed a retrospective chart review study of women seeking contraception at an innercity resident obstetrics/gynecology clinic. We compared 194 women with IUDs vs. 191 women receiving DMPA. Mean age was 31.9 years, with 75.1% and 69.2% being nonwhite and single, respectively. More white women received the IUD (34.5% vs. 15.0%, p < 0.001), and significantly more single women received DMPA (85.2% vs. 53.9%, p < 0.001).


RESULTS
After controlling for potentially confounding variables, DMPA women were significantly more likely to have a subsequent STD, although this effect disappeared when interaction terms were added to the model. Overall, duration of contraception use and being black were the best predictors of subsequent STD infection. Women who received IUDs were more likely to report side effects but less likely to discontinue use of their birth control (18.8% vs. 67.0%, p < 0.001).


CONCLUSIONS
Although sexual risk factors may have influenced provider prescribing practices in selecting IUD or DMPA, overall rates of STDs and discontinuation rates for IUDs were equivalent or superior to rates for DMPA.
Cropsey
Karen L
KL
Department of Psychiatry, University of Alabama at Birmingham, Birmingham, Alabama 35209, USA. kcropsey@uab.edu
Matthews
Catherine
C
Campbel
Samuel
S
Ivey
Sara
S
Adawadkar
Swati
S
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects / Q000706:statistics & numerical data*; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
D003271:Contraceptive Agents, Female; D017258:Medroxyprogesterone Acetate