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  • Title: Contraception and sexually transmitted diseases: interactions and opportunities.
    Author: McGregor JA, Hammill HA.
    Journal: Am J Obstet Gynecol; 1993 Jun; 168(6 Pt 2):2033-41. PubMed ID: 8512049.
    Abstract:
    Today "safe sex" means protection from both unintended pregnancy and sexually transmitted disease and human immunodeficiency virus. These parallel complications of sexual activity have serious biologic and clinical sequelae that should be considered at the time of contraceptive selection. In addition, there is ongoing debate regarding potential interactions between antibiotic intervention and contraceptive steroids. This article assesses the impact of hormonal contraception, spermicides, barrier methods, intrauterine devices, and douching on the pathogenesis of sexually transmitted disease and the human immunodeficiency virus infection. It discusses the direct and indirect effects of contraception methods on clinical physiology and host immune responses while also considering the possible consequences on maternal and infant health if pregnancy results from the use of ineffective contraception. Counseling and care for both family planning and infectious disease protection must be provided to all sexually active individuals. 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.
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