Combined hormonal contraception may be protective against Neisseria gonorrhoeae infection.
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 chi 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.
Gursahaney
Priya R
PR
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Meyn
Leslie A
LA
Hillier
Sharon L
SL
Sweet
Richard L
RL
Wiesenfeld
Harold C
HC
D000293:Adolescent; D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage*; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D009344:Neisseria gonorrhoeae; D012725:Sexual Behavior; D016896:Treatment Outcome; D014526:Urethritis / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D002575:Uterine Cervicitis / Q000382:microbiology / Q000517:prevention & control*; D055815:Young Adult
D003271:Contraceptive Agents, Female; D003278:Contraceptives, Oral, Hormonal; D017258:Medroxyprogesterone Acetate