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Contraception in the prepill era.

Although medical history has documented the desire to control fertility since ancient times, safe and effective contraception did not exist until this century and has not been equally available to all people. Strong moral sentiments, economic and social class factors, religious beliefs, familial and gender relations, and political as well as legal constraints have often limited the ability of physicians in favor of contraception to provide advice and methods of birth control to their patients. By the early 1900s, a constellation of factors--in particular, the large influx of poor immigrants, and feminist groups advocating women's rights--helped to move forward a birth-control movement in this country and abroad. In the early 20th century, Margaret Sanger became one of the most avid proponents of contraception in the United States. By 1950, she and Katharine McCormick had contracted with biologist Gregory Pincus to develop an effective birth control pill. A collaborative effort by Pincus and other researchers led to trials of the pill in Puerto Rico, Haiti, and Mexico between 1956 and 1957, which provided the basis for an application to the Food and Drug Administration for approval of the first oral contraceptive.

Animals↗

Intrauterine devices: learning from the past and looking to the future.

This paper reviews the historical development of the IUD, describing the challenges and successes, and attempts to offer a balanced perspective for family planning service workers today. Modern IUDs are an important component of family planning services and an excellent contraceptive choice for properly screened women, providing contraception that is safe, effective, long lasting and cost effective. Potential research strategies for the future are also discussed.

Family Planning Services↗

Safer sex now and then.

That longstanding aid to non-procreative sex, the condom, may have come into its golden age in the time of the AIDS epidemic. Di Tibbits sheds some light on the condom's dark past, and looks at the history of other methods of safer sex.

Australia↗

A condom sense approach to AIDS prevention: a historical perspective.

Condoms have come a long way since their use in ancient Egypt three millennia ago. Their benefit is well established for the prevention of both contraception and STDs. Although AIDS has revitalized the condom, we must remember that condoms do not prevent the spread of HIV infection, people do. Everyone must take personal responsibility to avoid high risk behavior (e.g.; IV drug use, promiscuous sex, casual sex, etc). If one does engage in high risk sexual behavior, he/she should at least use condom sense.

Acquired Immunodeficiency Syndrome↗

[Is today's condom better than its reputation?].

In a statistical sample of 500 unwanted pregnancies surprisingly the share of women whose partners used a condom was not higher than the share of IUP-users (considering the relative frequency of use of both methods). This result was the motivation to investigate once more the use of the condom. After a short description of the history, the production, and the testing methods a discussion follows of the frequency of its use. In many countries the frequency of using the condom lies between that of hormonal oral contraceptives and the IUP. Today the reliability of the condom is higher than described in medical textbooks. In statistics of the seventies the failure rate is no more than 3 unwanted pregnancies in 100 years of usage. Harmful side effects or contraindications are not known. Therefore in cases of incompatibility or refusion of hormonal oral contraceptives reflections of the doctor on useful alternative methods of contraception should include the recommendation of the condom.

Contraceptive Devices, Male↗

Contraceptive use and the risk of HIV infection in Nairobi, Kenya.

OBJECTIVES: To determine: (a) the prevalence of human immunodeficiency virus-1 (HIV-1) infection among women attending family planning clinics in Nairobi; and (b) the associations between contraceptive use and HIV infection. METHODS: History, clinical examination and laboratory tests were used to obtain data from 4404 women attending family planning clinics in Nairobi. We conducted a case-control study comparing HIV seropositive and seronegative women with regard to previous and current use of contraception. RESULTS: The overall prevalence of HIV-1 infection was 4.9% (95% C.I. 4.3-5.5). Previous and current use of oral contraceptives (OC), injectable contraceptives and the intrauterine device were not associated with a significant increase in risk, while current users of condoms had a non-significant reduction in risk. OC use was significantly associated with cervical ectopy, but no significant association was evident between ectopy and HIV infection. CONCLUSION: The finding of no significant association between past or current OC use and risk of HIV infection suggests that any independent association that may exist between OC use and HIV risk is not large.

Adolescent↗

[Problems in the evaluation of contraceptives (author's transl)].

For the evaluation of the effectiveness of contraceptives the Life Table method is at present the best method. It is a disadvantage that the original method of Tietze & Potter was restricted to the evaluation of intra-uterine contraception devices. A Belgian team is now in the process of developing a modified life table method for the evaluation of the effectiveness and the side effects of oral contraceptives. The reference to the Pearl-index for the effectiveness of contraceptives is unclear and in the way in which it is at present used scientifically untenable.

Clinical Trials as Topic↗