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American Journal of Epidemiology Vol. 144, No. 5: 512-520
Copyright © 1996 by The Johns Hopkins University School of Hygiene and Public Health

other

Association between Use of Spermicide-coated Condoms and Escherichia coli Urinary Tract infection in Young Women

Stephan D. Fihn1,3,, Edward J. Boyko1,2,4, Esther H. Normand5, Chi-Ling Chen4, Jane R. Grafton6, Marcia Hunt5, Patricia Yarbro5, Delia Scholes4,5 and Andy Stergachis6

1Northwest Health Services Research and Development Reid Program, Veterans Affairs Medical Center Seattle, WA
2Department of Medicine, University of Washington Seattle, WA
3Department of Health Services, University of Washington Seattle, WA
4Department of Epidemiology, University of Washington Seattle, WA
5Center for Health Studies, Group Health Cooperative of Puget Sound Seattle,WA
6School of Pharmacy, University of Washington Seattle, WA

Reprint requests to Dr. Stephan D. Finn, Health Services Research Program, Seattle Veterans Affairs Medical Center (152), 1660 S. Columbian Way, Seattle, WA 98108.

Diaphragm/spermicide use increases the risk of urinary tract infection (UTI). To determine whether Spermicide-coated condoms are also associated with an increased risk of UTI, the authors conducted a case-control study at a large health maintenance organization in Seattle, Washington. Cases were sexually active young women with acute UTI caused by Escherichia coli, identified from computerized laboratory files during 1990–1993. Age-matched controls were randomly selected from the enrollment files of the plan. Of 1, 904 eligible women, 604 cases and 629 controls (65%) were interviewed. During the previous year, 40% of the cases and 31 % of the controls had been exposed to any type of condom. The unadjusted odds ratio for UTI increased with frequency of condom exposure from 0.91 (95% confidence interval (Cl) 0.65–1.28) for weekly or less during the previous month to 2.11 (95% Cl 1.37–3.26) for more than once weekly. Exposure to spermicide-coated condoms conferred a higher risk of UTI, with odds ratios ranging from 1.09 (95% Cl 0.58–2.05) for use weekly or less to 3.05 (95% Cl 1.47–6.35) for use more than once weekly. In multivariate analyses, intercourse frequency (odds ratio (OR) = 1.14 per weekly episode), history of UTI (OR = 2.64), and frequency of spermicide-coated condom exposure (OR = 3.34 for more than once weekly and 5.65 for use more than twice weekly) were independent predictors of UTI. Spermicide-coated condoms were responsible for 42% of the UTIs among women who were exposed to these products. Am J Epidemiol 1996; 144: 512-20.

case-control studies; condom; Escherichia coli; spermicidal agents; urinary tract infections


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