Contraceptive Use Among Cisgender Women with Bacterial Sexually Transmitted Infections: A Cross-Sectional Study

Abstract

Little is known about contraceptive use among women with bacterial sexually transmitted infections (STIs), despite their high risk for unplanned pregnancy. This analysis describes contraceptive use and interest in long-acting reversible contraception (LARC) among women with bacterial STIs. This cross-sectional study included 1,623 women ages 13 to 45 with bacterial STIs who completed a public health Partner Services interview between January 2017 and December 2019 in King County, WA. For women not using LARC and not planning pregnancy, public health disease intervention specialists (DIS) delivered a brief educational message on LARC and assessed interest in switching to LARC. Contraceptive method type was divided into two groups consisting of highly or moderately effective methods and least effective, other, or no method. We conducted univariate analyses between individual level factors and contraceptive method followed by a multivariate logistic regression analysis adjusting for factors found to be statistically significant in the univariate analyses. Just over half of the women (52.8%) interviewed reported using highly or moderately effective contraception. Black women were less likely to use a highly or moderately effective method compared to White women (aRR 0.58, 95%CI 0.43-0.80) and women with private insurance were more likely to use a highly or moderately effective method compared to those with public insurance (aRR 1.67, 95% CI 1.28-2.19). After brief counseling, fewer than one in five women were interested in switching to LARC. These data suggest there is an opportunity for public health partner services to fill an unmet need for contraception access and reproductive health programming more intensive than brief educational counseling is likely needed to increase LARC use among women with bacterial STIs.