The decision to be sexually active involves two health risks for women: unwanted pregnancy and sexually transmitted diseases. Use of contraception affects both these risks. Data from the Metropolitan Health Department in Nashville, Tennessee, were examined to determine the effects of particular contraceptive methods on gonococcal infection in women. The results suggest that not only barrier methods but also other types of contraception were associated with protection against gonorrhea in females. The use of contraception was unusually high (87%) among the study population of 1,303 women. Five hundred eighteen (40%) of these clinic attendees were infected with Neisseria gonorrhoea. Infected women tended to be younger than those not infected and were significantly more likely to be black than white and somewhat more likely to be single. Contraceptors tended to be younger and were more likely to be black than were noncontraceptors.
PIP: The effects of particular contraceptive methods on gonococcal infection were examined in 1303 women attending a public venereal disease clinic during 1979. 1132 (87%) of clinic attenders were using some method of fertility control. The major methods in this series were oral contraceptives, 47%; surgical methods, 18%, and IUDs, 12%. Barrier methods accounted for 5% of contraceptive usage. Of all the women who came to the clinic, 518 (40%) were actually infected with N gonorrhoeae. Those infected with N gonorrhoeae were likely to be younger than those not infected and were more often black and single. Significantly more noncontraceptors than contraceptors were black and young (under 20 years of age). Women not using contraceptives were over 3 times more likely to be infected than contraceptive users (94% infection rate versus 30%). All methods of contraception provided some degree of protection against gonococcal infection. Barrier methods appeared to have the strongest protective effect; only 9.4% of barrier method users were infected (relative risk 0.11). In some cases, the relationship observed in this study between use of specific contraceptive methods and lower rates of gonorrhea may be biological. The explanation in other cases may be behavioral: women who use birth control may be less risk taking in their sexual behavior. It is concluded that motivating women to use contraception, especially barrier methods, could help reduce the incidence of sexually transmitted diseases. Extrapolation of the findings of this study suggests that nearly 200,000 of the 250,000 cases of gonorrhea reported in the US in 1983 could have been averted by use of barrier methods of contraception on the part of noncontraceptors and those using nonbarrier methods.