Intrauterine Devices and Sexually Transmitted Infection among Older Adolescents and Young Adults in a Cluster Randomized Trial

El Ayadi, et. al

JPAG 2021; 34 (2021) 355e361 

  1. The primary outcome for this secondary analysis was new diagnosis of GC/CT captured via 2 sources, self-report from surveys and medical record data. 
    • GC/CT is used as the primary etiologic agent of PID, but we have come to understand that this is a polymicrobial diagnosis. How do you think this data point impacts PID incidence data?
    • How might self-report of GC/Chlamydia rates be problematic?

  2. PID is a clinical diagnosis: discuss the impact of self-reporting in this study. The authors acknowledge that there is no data regarding self reporting of PID, and self-reported history of chlamydia commonly yields both false negative and false positive results.  Further, there was no medical record capture of PID so not possible to confirm. 
    1. How could this stufy have been structured differently to ensure researchers not under reporting GC/Chlamydia and PID?

  3. This study focuses on older adolescents and young adults, aged 18-25 years of age.  Do you think these findings are extrapolatable to younger adolescents where LARC use remains low?

  4. What areas of future research naturally follow this study?