Egypt's FOF shifts into high gear.
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Results for “Vaginal Barrier Methods”
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Contraception in the adolescent. Preparation for the 1990s.
An overview of current and future contraceptive methods available to the adolescent is presented. Emphasis is given to oral contraceptives, including low-dose monophasics and triphasics. Current research confirms the efficacy and safety or oral contraceptives for teenagers. Other methods are reviewed, such as the mini-pill, barrier contraceptives (including the cervical cap and female condom), injectable contraceptives, hormonal contraceptive implants, the vaginal ring, postcoital contraception, periodic abstinence, gossypol, and others. Though abstinence is the best contraceptive method for adolescents, contraceptive technology of the 1990s presents clinicians and sexually active youth with many additional options.
Adolescent↗
Social marketing program sales.
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Africa↗
Birth control method choice and use of barrier methods for sexually transmitted disease prevention among low-income African-American women.
In a prospective study of 1122 women attending a sexually transmitted disease (STD) clinic in Alabama, consistent use of the male condom and vaginal microbicide/spermicides was promoted to reduce STD risk. This analysis evaluated: 1) baseline characteristics that may influence birth control method choice; and 2) the association of birth control method and other baseline characteristics with consistency of barrier use during follow up. Birth control method was associated with sociodemographic variables, sexual, and reproductive history. Women who adopted user-independent methods (tubal ligation, implants, injectable hormones) appear to have completed their family plan. Oral contraceptive users were of higher socioeconomic status and at lower STD risk. Barrier method users and women who used no method were young and at higher STD risk. Consistency of condom/spermicide use increased in all groups. Barrier method users were more likely than other women to use condoms and spermicides during the study. Women who used no birth control method at baseline experienced the largest increase in barrier use during follow up, although their barrier use rates were lower than in other groups. The synergism between the intention to prevent pregnancy and the intention to prevent STD should be considered in the design of interventions promoting condom use.
Adolescent↗
Allergic contact dermatitis of the genitals from rubber additives in condoms.
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Adult↗
Methods of contraception and rates of genital infections.
Bacterial vaginosis, trichomoniasis and candidiasis are the most common genital infection. The aim of this study was to evaluate the various methods of contraception with regard to the prevalence of bacterial vaginosis and vulvo-vaginitis over a period of four years. We also evaluated in the same period the rates of trichomoniasis, candidiasis, bacterial vaginosis and vulvo-vaginitis between users and non users of contraceptional methods and the relationship between ages of patients and types of contraceptives. Finally we considered the change of contraceptive use with regard to age among two different periods. The IUD users showed a significant increase of B.V., T.v. and other bacteria and a decrease of the negatives compared to OC users. Barrier contraceptive users had a reduction (0.01 > p > 0.001) of B.V. and an increase (p < 0.001) of the negatives compared to IUD users. OC users had a significant (p < 0.05) increase in candidiasis, B.V. together with a reduction of the negatives compared to non users group. IUD users had a significant (p < 0.001) increase of B.V. and vulvo-vaginitis from other bacteria, and the reduction of the negatives. Teenagers use OC much more than adults, but less IUD (p < 0.001). The use of OC has increased and the use of IUD decreased among adults (p < 0.001). The barrier methods were seen to be statistically reduced.
Adult↗
Adhesion ability of Lactobacillus to vaginal epithelial cells: study by microbiological methods.
Adhesion of lactobacilli to the epithelium has been described as the first step in the formation of a barrier to prevent undesirable microbial colonization; consequently, it has been defined as a characteristic of interest for selecting probiotic strains. Several methods have been described to predict the adhesion ability of Lactobacillus. Early studies were phenomenological: it was useful to determine whether a particular bacterium could hemagglutinate, or bind to coated particles. Later, studies based on the adhesion of bacteria to epithelial cells in vitro were developed. These last assays were based on the numbers of bacteria attached to epithelial cells, which were determined by counting stained microorganisms under light microscopy or by measuring the radioactivity of previously radiolabeled bacteria. Because the microscope technique, had some disadvantages, a modification was developed in our laboratory. The technique described in this chapter is a modification of the Mardh and Weströn method. The method allows the study of the adhesion ability of bacteria, even if they are aggregating or if they are high-adherent bacteria covering a large area of the epithelial cell surface. Determination of the number of adherent bacteria by counting colonies grown in a selective media avoids the time-consuming, tedious, and hazardous counting under the light microscope and the use of radioactive methods.
Animals↗
Barrier methods of contraception: a reappraisal.
In the last two years, there has been a gradual reawakening of interest in barrier methods and an increase in their usage by both men and women. This is in large part due to concern about the sometimes serious side effects reported for other contraceptive methods. The return to these techniques is particularly important, given the current epidemics of teenage pregnancy and veneral disease. One of the major problems in relation to barrier methods today is the accurate determination of their efficacy. There are very limited data with statistical validity available to judge the exact rate of effectiveness one might obtain using one of these techniques. The National Survey of Family Growth, conducted by the National Center for Health Statistics, showed a failure rate per 100 women of 16.7 for foam, cream or jelly and 15.9 for diaphragms (22). There is a great need for new and improved barrier methods of contraception. Numerous clinical studies are being set up to test spermicidal agents and vaginal sponges for the female, as well as such things as disposable condoms for males.
Adolescent↗
SOMARC teams with private distribution firm to implement CSM program in Ghana.
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Prospective study of barrier contraception for the prevention of sexually transmitted diseases: study design and general characteristics of the study group.
BACKGROUND AND OBJECTIVES: The AIDS epidemic has brought barrier contraceptives to the forefront of public health research. A comprehensive evaluation of the efficacy of barrier contraceptive use in preventing sexually transmitted diseases (STDs), including AIDS, is necessary to inform both potential users and public health policy makers. This study was undertaken to evaluate the efficacy of condoms and vaginal spermicide products, used alone or in combination, in preventing gonorrhea and chlamydia among women attending an STD clinic. GOAL OF THIS STUDY: To describe the general characteristics of the study group and its follow-up experience. STUDY DESIGN: Women who met the eligibility criteria were invited to participate. The initial visit included an interview, a behavioral intervention promoting barrier methods, a physical examination, and instructions to complete a sexual diary. Participants received free barrier contraceptives and returned for six monthly follow-up visits. DESIGN RESULTS: Participants (n = 1,122) were low income, single (74%) black (89%) women with a median age of 24. The behavioral intervention led to the use of barrier protection in more than 70% of reported acts of vaginal intercourse. Barriers were used consistently (100% of sexual acts) during 51% of the months of follow-up. A total of 148 cases of gonorrhea (28 per 1,000 months) and 122 cases of chlamydia infection (23 cases per 1,000 months) were diagnosed during follow-up. CONCLUSION: This study represents a practical solution to a complex set of design considerations. The study protocol was successful in promoting consistent and proper use of barrier methods.
Adult↗
Spermicides 2002: an overview.
The first-ever written prescription for a contraceptive (barrier method) tampon can be found in the Ebers Papyrus, a compendium of medical practices written in 1550 BC. Modern spermicides are produced in a variety of formulations, including gels, foams, creams, suppositories, pessaries, capsules, foaming tablets and films. Spermicides are relatively inexpensive and widely available over the counter. Most of the currently used spermicides contain the chemical agent (non-ionic detergent) nonoxynol-9. The spermicide 'as a commonly used method' has a very high failure rate (one pregnancy in every four women using this method of contraception for 1 year). Implementation of other, much more effective methods of contraception has made spermicides less and less popular, but recently their potential properties against HIV and STI pathogens (a cause of sexually transmitted diseases) have led to new attention for these products. These properties have been widely evaluated in clinical trials, but the final conclusion does not favor spermicides as the tool for the global fight against HIV/AIDS. There is an urgent need for the invention of a chemical product that, for dual protection, would be administered vaginally before sexual intercourse to kill HIV and other STI pathogens, and at the same time disable or kill sperm. The new era for barrier methods should begin from the development of novel microbicides.
Contraception↗
Contraception in the adolescent: an update.
Contraception remains an important part of national efforts to reduce adolescent pregnancy in the United States. A number of safe and effective contraceptive methods are available for our youth, including abstinence, barrier methods, oral contraceptives, Depo-Provera, and Norplant. Research over the past few decades has resulted in a variety of oral contraceptives with reduced amounts of hormones and reduced side-effects. A number of methods have received approval by the Food and Drug Administration since the last review in 1980, including emergency contraceptives, depomedroxyprogesterone acetate, and the cervical cap. The use of condoms and vaginal spermicides continues to be recommended for all sexually active adolescents to reduce (not eliminate) the risk for acquiring sexually transmitted diseases. A polyurethane condom is now available, in addition to the latex condom and other barrier contraceptives, including the following: diaphragm, cervical cap, vaginal sponge, female condom and vaginal spermicides. Because of continuing concerns about pelvic inflammatory disease related to intrauterine devices, currently available intrauterine devices are not recommended for most adolescents. Abortion is not considered as a contraceptive method.
Adolescent↗
The effectiveness of barrier methods of contraception in preventing the spread of HIV.
Because barrier methods provide protection against bacterial sexually transmitted diseases, these methods are valuable public health adjuncts irrespective of their effect on HIV. Male latex condoms offer substantial protection against HIV infection. Women at risk of sexual acquisition of HIV infection need one or more prophylactic methods that they can control. While the available spermicide products may serve this purpose, current data do not allow firm casual inferences. Large and well designed epidemiologic studies are required to examine the association between female use of barrier methods and HIV infection. These are difficult and costly to perform, however, and to date have yielded conflicting results. Finally, prospective studies in high-incidence cohorts are necessary, and the relationships between spermicide use, local irritation, the vaginal flora and HIV incidence rates must be clarified.
Condoms↗
Effect of 3-hydroxyphthaloyl-beta-lactoglobulin on vaginal transmission of simian immunodeficiency virus in rhesus monkeys.
Heterosexual transmission of human immunodeficiency virus type 1 (HIV-1) is the major cause of the ongoing AIDS epidemic. Application of chemical barrier methods is expected to contribute to the worldwide control of this epidemic. Bovine beta-lactoglobulin modified by 3-hydroxyphthalic anhydride (3-hydroxyphthalovyl-beta-lactoglobulin [3HP-beta-LG]) was shown to inhibit HIV-1, HIV-2, simian immunodeficiency virus (SIV), herpes simplex virus type 1 and 2, and Chlamydia trachomatis infection in vitro. Here, we show that 3HP-beta-LG not formulated into any vehicle protected three of six rhesus monkeys against vaginal infection by SIV. Incorporation of the compound into an appropriate vehicle is expected to increase the degree of protection. 3HP-beta-LG may be effective as a vaginal inhibitor of HIV-1 infection in humans.
Acquired Immunodeficiency Syndrome↗
Barrier methods.
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Contraceptive Devices↗
Barriers to conception and disease.
For the purpose of this review, ¿barriers¿ are defined as any method used during or after intercourse that physically or chemically isolates semen. Latex condoms for men are the best studied physical barrier and offer high efficacy as both a contraceptive and as protection against several major sexually transmissable diseases (STD), particularly human immunodeficiency virus (HIV). Limited acceptability and dependence on male cooperation limit their ¿use effectiveness¿ in non-commercial sex or when the receptive partner is disempowered. Polyurethane male condoms may improve acceptability and prove stronger and more durable. Female-dependent methods require further study which may net real benefits for containing the spread of STD/HIV infections in the short to medium term. Female condoms and newer non-toxic intravaginal chemicals offer much promise. Similarly, the female diaphragm warrants further investigation and should be given more prominence at least as a second-line measure. Withdrawal and post-coital intravaginal chemical prophylaxis may have been previously underestimated as occasionally useful strategies, particularly for reducing the risk of pregnancy and HIV infection for those that were otherwise unprepared for sex. The only role for vasectomy is as a contraceptive measure, while vaginal or anal douching is contraindicated as a reproductive health measure because of the risk of pelvic inflammatory disease and other ectopic pregnancy. There is ample room for developing a more diverse range of better barrier products as well as better promoting those methods that already exist. We already have the means available to us to halt the spread of HIV. Moral arguments against barrier methods have no scientific basis.
Contraception↗
A comparative clinical trial of the contraceptive sponge and Neo Sampoon tablets.
Neo Sampoon, a foaming vaginal tablet containing 60 mg of the spermicide menfegol, and the Collatex sponge (now marketed in the United States as the Today sponge), a dome-shaped polyurethane device that contains 1 g of nonoxynol-9, were compared in terms of effectiveness, safety, and acceptability. Both methods were new to the Maribor General Hospital, Yugoslavia, where the trial was conducted among 450 volunteers randomly assigned to one of the two methods. At 12 months, the life-table pregnancy rate per 100 women for the Neo Sampoon group was 12.8, compared with a rate of 10.4 among the sponge users (P greater than .10). After pregnancy, the second most frequent reason for termination was discomfort, with a 12-month termination rate due to this cause of 6.9 per 100 women in the Neo Sampoon group and 6.2 in the sponge group. Although fewer than a quarter of the volunteers had any experience with barrier methods before this trial, the life-table continuation rate was high in both groups, with more than 70% using their assigned method for the full 12 months. Also, upon conclusion of the study, 41% of the volunteers chose another barrier contraceptive method. Although the effectiveness of the sponge and Neo Sampoon is not comparable to that of the pill or IUD, both vaginal methods appear to be safe and acceptable additions to the range of contraceptive choices.
Actuarial Analysis↗
Alternatives to vaginal intercourse practiced during the fertile time among calendar method users in Ireland.
A pilot study was conducted in Ireland to test the effectiveness of the calendar method of contraception. A conservative rule was used, requiring on average 16 days of abstinence per cycle. Among the 19 couples who entered into the study and were followed for up to seven cycles, there were no pregnancies. Since the length of abstinence was relatively long, we collected data to determine how couples expressed love and affection towards each other during those days when the woman was potentially fertile. We also collected data about barrier method use during the fertile time. We found that almost all couples gave each other hugs and kisses to show affection although couples were taught to abstain from vaginal intercourse during the fertile time. About one-third of the couples avoided genital contact, while about half reported using oral sex and/or frottage (body rubbing). Twice as many men reported using masturbation compared to women, although about half of the couples practiced mutual (partner) masturbation. In addition, about one-fifth of the couples used condoms during the fertile time in some cycles. These findings show that a variety of sexual expressions are used by couples when vaginal intercourse is to be avoided. Knowledge about these alternative sexual expressions may be important for couples who wish to engage in sexual activity and to avoid pregnancy.
Coitus↗