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

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.