Evidence map›Paper›PMID 42618326›Full record

ArticleBMJ global health2026

Long-acting reversible contraception, condom use and sexually transmitted infections in developing countries: a multi-country serial cross-sectional analysis using demographic and health surveys.

Nan Zhang, Luyao Xie, Yingxuan Wang, Zihao Guo, Cheng Su, Qiaoge Chi, Salihu S Musa, Kailu Wang, Kai Wang, Ka Chun Chong and 5 more

Abstract read
In one paragraph

Article in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Nan Zhang *School of Public Health, Tianjin Medical University, Tianjin, China.ORCID 0009-0004-6097-9238
Luyao Xie *JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.
Yingxuan Wang *School of Public Health, Tianjin Medical University, Tianjin, China.ORCID 0000-0001-7869-0599
Zihao GuoSchool of Public Health, Tianjin Medical University, Tianjin, China.
Cheng SuDepartment of Infectious Disease Control and Prevention, Tianjin Centers for Disease Control and Prevention, Tianjin, China.
Qiaoge ChiDepartment of Biomedical Sciences, City University of Hong Kong, Hong Kong, China.
Salihu S MusaDepartment of Genomics and Computational Biology, UMass Chan Medical School, Worcester, MA, USA.
Kailu WangJC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.
Kai WangDepartment of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China.
Ka Chun ChongJC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.ORCID 0000-0001-5610-1298
Nafiu HussainiDepartment of Mathematical Sciences, Bayero University, Kano, Nigeria.
Yuantao HaoPeking University Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China.
Abdulrazaq G HabibInfectious and Tropical Diseases Unit, Department of Medicine, Bayero University, Kano, Nigeria.
Yang GeDepartment of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia, USA zhaoshi.csma@gmail.com yang.ge@uga.edu.
Shi ZhaoSchool of Public Health, Tianjin Medical University, Tianjin, China zhaoshi.csma@gmail.com yang.ge@uga.edu.ORCID 0000-0001-8722-6149

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionUnintended pregnancy and sexually transmitted infections (STIs) are major public health issues in developing countries. While long-acting reversible contraception (LARC) effectively prevents unintended pregnancy, there is limited evidence from large multinational studies on its association with condom use and STI-related outcomes. This study aimed to investigate the association between LARC use, condom use and STIs among women in developing countries.

methodsThis serial cross-sectional study extracted data from Demographic and Health Surveys (DHS), a series of nationally representative household surveys conducted in developing countries. The analysis included women aged 15 to 49 years, with data on contraceptive methods and demographics. Generalised linear mixed effect models (GLMMs) were used to estimate adjusted prevalence ratios (aPRs) for condom use and self-reported STI-related outcomes, comparing LARC users with both non-LARC users and oral contraceptive users. Subgroup analyses were conducted at the individual level and at the country level.

resultsData from 2 171 884 women across 31 countries were analysed. Overall, the prevalence of self-reported STI-related outcomes was 7.4%, 3.9% of participants used LARC, and 7.5% of participants reported consistent condom use. LARC users were significantly less likely to use condoms compared with non-LARC users (aPR=0.40, 95% CI 0.30 to 0.53) and compared with oral contraceptive users (aPR=0.61, 95% CI 0.48 to 0.78). LARC use was associated with a higher prevalence of STI-related outcomes compared with non-LARC users (aPR=1.19, 95% CI 1.10 to 1.28) and compared with oral contraceptives users (aPR=1.14, 95% CI 1.05 to 1.24). Associations were stronger in low-Human Development Index (HDI) countries, especially among younger women (15-19 years), but were not significant in high-HDI countries. Country-level heterogeneity was observed.

conclusionsLARC use is associated with reduced condom use and higher self-reported STI prevalence, particularly among younger women and in lower HDI developing countries. These findings support integrating STI prevention into LARC services and promoting dual-method use to prevent both unintended pregnancies and STIs.

Indexed as

CondomsDeveloping CountriesLong-Acting Reversible ContraceptionSexually Transmitted DiseasesAdolescentAdultCross-Sectional StudiesFemaleHealth SurveysHumansMiddle AgedPregnancyPregnancy, UnplannedPrevalenceYoung AdultCross-sectional surveyGlobal HealthHIVIncidencePregnancy

Identifiers

PMID42618326
PMCPMC13504946

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.