Contraception and sexually transmitted diseases: interactions and opportunities
McGregor, J.A.; Hammill, H.A.
American Journal of Obstetrics and Gynecology 168(6 Part 2): 2033-2041
1993
ISSN/ISBN: 0002-9378 PMID: 8512049 DOI: 10.1016/s0002-9378(12)90946-1Document Number: 326035
The notion of safe sex currently denotes protection from unintended pregnancy, HIV, and other sexually transmitted diseases (STD). Modern parallel complications of sexual activity should therefore be considered when selecting contraceptives. This article assesses the impact of hormonal contraception, spermicides. barrier methods, IUDs, and douching on the pathogenesis of STDs and HIV. It discusses the direct and indirect effects of contraception methods on clinical physiology and host immune responses while considering the possible consequences on maternal and infant health if pregnancy results from the use of ineffective contraception. It is concluded that significant interactions exist between forms of contraception and STDs and HIV which may be beneficial or harmful to women. For example, oral contraceptive (OC) use may reduce risks of pelvic inflammatory disease and its sequelae, but may increase risks of chlamydia infection. Barrier methods, especially when combines with spermicides, can reduce the risk of STDs/HIV if used consistently. The combined use of OCs and condoms offers serious defense against both unintended pregnancy and STDs/HIV. IUDs also seem safe and effective in women at low risk for reproductive tract infection. Periodic screening and treatment for prevalent STDs and possible bacterial vaginosis can protect the health of individuals and their sexual contacts. Finally, more research is needed on the reproductive and infectious disease repercussions of human sexuality, while counseling and care for family planning and infectious disease protection are recommended for those who are sexually active.