Abby Benning

921 6th Ave, Apt 516

Des Moines, IA 50309
Phone: 319-242-2869
Email: benningabby2@gmail.com
25 November 2018

The Editor
Des Moines Register
Dear Sir or Madam

The scientific study “Hormonal contraception and risk of sexually transmitted disease
acquisition: Results from a prospective study” is one of the first to examine contraceptive use
and STDs. Though the study used a population of Kenyan sex workers, the statistical results and
findings can be applied to the general population. The authors discuss the demographic and
behavioral differences between the sex workers, taking into account the place of work (bar vs
nightclub), age, years of education and prostitution, number of sexual partners and contacts,
and condom usage. I support the study due to the reliable and accurate methods used. I
especially applaud the recognition of the effects of estrogen and progesterone, the hormones
used in contraceptives, on the reproductive system and the bacteria that cause sexually
transmitted disease. Not only do the results provide information on the behavior of
contraceptive use related to sexually transmitted disease but also microbial effects related
contraceptive use and sexually transmitted disease bacteria. Because the sample population
was of those in the sex work industry, it predictably provides a more consistent sexually active
population.
The sample’s consistent sexual contact was what provided much insight as the sex workers
were screened on a monthly basis. In this study, the oral contraceptive pill was associated with
elevated risks of chlamydial infections and vaginal candidiasis with an association in decreased
risk of bacterial vaginosis. DMPA, an injectable hormonal contraceptive, use was also associated
with elevated risks of chlamydial infections with a decrease in the risk of trichomoniasis, pelvic
inflammatory disease, and bacterial vaginosis, also. Contraceptive use and the increased or
decreased risk of microbial infections is recognized to have a relationship between their
hormonal influences. Of all the information provided from the study, the conclusion that “100%
condom use was associated with decreased risk of the majority of the STD outcomes we
evaluated”, is perhaps the biggest take-away (Baeten et al). The study was done on a sexually
active population and the findings are just as applicable to the whole population of sexually
active individuals.

While contraceptive use should continue to be advocated for, the advocacy of condom use
should be just as important. Contraceptive users are at an increased risk of sexually transmitted
disease and regardless if it’s due to the relation of the hormonal effects or behaviors
surrounding condom use, this study reiterates the importance of using condoms. This
information provides great reason for public and private organizations to do more to promote
the use of condoms, along with contraceptives, because as we know and as the study states,
STDs are a major cause of lost healthy life years in women of reproductive age.

Sincerely,
/s/Abby Benning

Enclosure:
References
 References
Baeten et al. (2000). Hormonal Contraception and Risk of Sexually Transmitted Disease
Acquisition. Retrieved from
https://s3.amazonaws.com/academia.edu.documents/46393670/Hormonal_contracept
ion _and_risk_of_sexua20160611-18928-
1l4h3zp.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1543183488&Sig
nature=6NsmsdPdLEzXUITQy%2BIlnIGJg84%3D&response-content-
disposition=inline%3B%20filename%3DHormonal_contraception_and_risk_of_sexua.pf.
Centers for Disease Control and Prevention. (2018). Sexually Transmitted Diseases (STDs).
Retrieved from https://www.cdc.gov/std/default.htm.
World Health Organization. (2018). Sexually Transmitted Infections (STIs). Retrieved from
http://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-
(stis).