Study Demonstrates Feasibility of Important Clinical Trial

Results of a USAID-supported survey suggests that women in South Africa and Jamaica would be interested in participating in a clinical trial to examine the possible relationship between hormonal contraception and increased risks of acquiring sexually transmitted infections (STIs). Results also show a high rate of STIs at the survey sites — another sign that a clinical trial would be feasible.

Clients from two family planning clinics and one STI clinic were given detailed information on a proposed trial in which women would be randomly assigned to use an intrauterine device or an injectable contraceptive. The clients then answered questions to determine how well they understood the study and how interested they would be in participating. They also provided urine or endocervical samples so that the scientists could determine their prevalence of STIs.

Nearly all of the 190 women who completed the survey appeared to understand the proposed trial well, and more than two-thirds expressed interest in participating. About 28 percent of the women tested positive for chlamydial infection, and 9 percent tested positive for gonorrhea.

Some observational studies have suggested that the use of hormonal contraception increases a woman's risk of acquiring STIs. Data from the largest prospective study ever conducted on this topic showed no association between the use of hormonal methods and acquisition of HIV. However, the study did not examine the relationship between use of the methods and acquisition of other STIs. A randomized controlled trial would help determine whether such a relationship exists and, if so, the nature of that relationship.

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Source
Hubacher D, Raymond ER, Beksinska M, et al. Hormonal contraception and the risks of STI acquisition: results of a feasibility study to plan a future randomized trial. Contraception 2008;77(5):366-370.