Hormonal and barrier methods of contraception, oncogenic human papillomaviruses, and cervical squamous intraepithelial lesion development

We assessed the influence of hormonal (oral, injectable, or levonorgestrel [Norplant, Wyeth-Ayerst, Philadelphia, PA]) and barrier methods of contrace ption on the risk of cervical squamous intraepithelial lesions (SIL), while adjusting for high-risk (HR) HPV infection. Subjects were women receiving family planning services through the state health department clinics from 1 995 to 1998. We selected 60 cases with high-grade cervical/SIL (HSIL) and 3 16 with low-grade cervical/SIL (LSIL) and controls (427 women with normal c ervical cytology) and analyzed cervical DNA for HR-HPV, using Hybrid Captur e I (Digene; Gaithersburg, MD). When assessing ever use, duration, recency, latency, and age at first use, neither oral contraceptives (OC), Norplant, nor injectable use was associated with an increased risk of SIL developmen t after adjusting for age, age at first sexual intercourse, and HR-HPV posi tivity. Among HR-HPV-positive women, longer duration barrier method use was associated with a reduced risk of SIL. This finding has important clinical implications for SIL prevention among HR-HPV-infected women.