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PubMed1994

Potential acceptability of ovulation detection kits and RU-486 at two college campuses.

Two innovations in fertility research may expand birth control options in the United States. Ovulation detection kits, used alone or in conjunction with barrier methods of contraception, could be used to chart the fertile period. RU-486, when used in conjunction with a prostaglandin, induces early abortion, providing an alternative to conventional vacuum aspiration abortion. To measure the hypothetical acceptability of these methods, the authors surveyed 710 women at two college campuses in California regarding potential use of ovulation detection kits and RU-486. Seventy-one percent of the women in the final sample indicated an interest in using ovulation kits. Of these women, most (72%) were interested in using an ovulation detection kit as a supplement to barrier methods, and 22% indicated they would consider the kit as a sole method of birth control. More than 68% of the women in the sample indicated they would choose an abortion if faced with an unwanted pregnancy, and 60% would hypothetically choose RU-486 in preference to a conventional pregnancy termination. The most frequently cited reason for preferring RU-486 rather than conventional methods of abortion was to avoid the risks associated with the vacuum aspiration technique.

Abortion, Induced↗
PubMed1988

Prostitution in Sheffield: differences between prostitutes.

This study to assess differences between street walking prostitutes and sauna girls who attended this clinic in 1986 and 1987 showed that fewer street walkers used barrier methods for disease prevention with clients or accepted tests for antibody to human immunodeficiency virus (HIV) when offered and more street walkers practised their profession in both Sheffield and London. They therefore represent a potential pathway for the heterosexual spread of HIV to the region. Trichomonas vaginalis was the only organism more commonly isolated from street walkers. Other sexually transmitted diseases diagnosed, and the sources of acquisition of gonococcal cervicitis, were similar in both groups of prostitutes. Prostitutes rarely used barrier methods with their regular consorts, who were found to be responsible for most cases of gonorrhoea in both groups. As 11 out of 58 prostitutes attending were found to have dysplasia on routine cervical cytological examination, we suggest that all prostitutes be advised to undergo cytology yearly.

Contraception Behavior↗
PubMed1981

Simultaneous measurement of cerebral blood flow and unidirectional movement of substances across the blood-brain barrier: theory, method, and application to leucine.

The uptake of compounds by the brain depends upon cerebral blood flow. To determine the normal blood flow-cerebral extraction relationship, a method for rapid, simultaneous measurement of cerebral blood flow and brain extraction was developed and applied to blood-brain leucine transfer. Awake rats were injected intravenously with a mixture of n-[(14)C]butanol and [(3)H]leucine. The quantities of indicators accumulated over the following 5-12 s in brain and in a sample of arterial blood withdrawn at a know rate were used to determine the flux of butanol and leucine into brain. Butanol extraction was assessed independently by measuring arterial and cerebral venous concentrations of the indicator after a bolus injection. Cerebral blood flow was equal to the ratio of butanol flux into brain to butanol extraction by brain; leucine extraction was then calculated as the ratio of leucine influx to cerebral blood flow. Leucine extraction by brain and cerebral blood flow were shown to be related exponentially. The maximum velocity of active leucine transport was virtually the same at flows of 150 and 400 ml/100 g/min. The present method is theoretically applicable to the measurement of the extraction of any compound from blood by brain. By measuring the normal blood flow-extraction relationship, one can differentiate changes in extraction secondary to altered flow from changes intrinsic to pathologic conditions with inconstant cerebral blood flow.

1-Butanol↗
PubMed2002

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↗
PubMedDate not supplied

Fertility and contraceptive adoption and discontinuation in rural Kenya.

After a long period of slow progress, the recent uptake of contraceptive use in Kenya has been dramatic. This report describes adoption of a method and method switching and discontinuation among a cohort of married women aged 25-34 in two contrasting rural areas. A retrospective "fertility diary" completed by each woman provided information on spousal separation, reproductive status, and contraceptive use over a period of 46-48 months. Contraceptive prevalence rose rapidly over the period in both areas, with significant net adoption of injectables in both areas and of IUDs in one only. Method discontinuation was concentrated among users of pills, barrier methods, and "natural" methods, and only one-third of all discontinuations were voluntary. The wide differences between the two rural areas in contraceptive prevalence were not totally reflected in recent fertility levels, and the contribution of other proximate determinants of fertility, particularly postpartum amenorrhea and spousal separation, are discussed.

Adult↗
PubMed1979

Use-effectiveness and client satisfaction in six centers teaching the Billings Ovulation Method.

Use-effectiveness of the Billings Ovulation Method (OM) is reported for 1139 clients from six centers who were followed for at least 24 months. Method failure rates were 1% when calculated by either Pearl formula or life table analysis. Combined method and user failure rates were 20% when calculated with the Pearl formula, and 16% at 12 months and 23% at 24 months by life table analysis. Pregnancy rates were higher for couples using OM alone, than for couples using OM in combination with additional fertility awareness methods or together with barrier methods. The difference was significant when estimated by the Pearl formula but not when analyzed by the life table. The emotional implications underlying the apparent contradiction between a desire to avoid pregnancy and the deliberate coital use of fertile days are reflected in the differences between method and user failure rates, the high client satisfaction levels reported with "user failure," and 56% continuation rate at 24 months. The will require in-depth exploration.

Abortion, Legal↗
PubMed1992

Awareness and practice of contraception among female students at the Institute of Management and Technology (IMT), Enugu.

A study of the knowledge, attitudes to and practice of contraception among the female students at the Institute of Management and Technology (IMT), Enugu, was carried out, involving 266 female students out of a total female student population of 1,510. The mean age of the population sample was 19.1 years and 254 (95%) were single. Ninety-six percent were aware of the availability of contraceptives. Knowledge relating to the practice of contraception was superficial since as many as 61% of the objectors believed that contraception subsequently led to infertility. One hundred and thirty (49%) of the studied population had used one form of contraception or another sometime in their lives. Seventy-six percent had not used any contraception for initial intercourse. The rhythm method followed by the barrier method were the most popular forms of contraception. Practice of contraception by the studied population was inconsistent as 21% of the students eventually had an unwanted pregnancy and 18% had an induced abortion. Health education is strongly recommended to our women folk in order to reduce the high incidence of unwanted pregnancy and its associated medical and social complications.

Adolescent↗
PubMed2000

Partner type and condom use.

OBJECTIVES: To examine the association between type of sexual partnership and condom use consistency. DESIGN: A prospective follow-up study of women attending two urban clinics for sexually transmitted diseases (STD). METHODS: Sexual diaries recording barrier method, partner initials and partner type for each act of intercourse were kept by 869 women. Condom use by partner type was evaluated in three ways in the entire group: among women who encountered multiple partners, during months in which women encountered multiple partners, and within sexual partnerships that changed status during the study. RESULTS: Consistency of condom use was higher with new and casual partners than with regular partners in the entire group and among women who encountered multiple partners. In months in which partners of different types were encountered, condom-use consistency was higher with new and casual partners than with regular partners. Consistent condom use decreased in partnerships that changed status from new to regular. The female condom was used more often with regular partners than with new or casual partners in the entire study group, among women who encountered multiple partners, and during months in which a woman achieved consistent use with her regular partner. CONCLUSIONS: This study provides strong evidence that condom use behavior is modified by partner type. Observations about condom use and partner type made in cross-sectional or retrospective surveys also hold in the present longitudinal analyses of individual women and of partnerships that change status. The female condom may be an important option for achieving consistent protection within stable partnerships.

Adolescent↗
PubMed1978

Barrier contraceptive practice and male infertility as related factors to breast cancer in married women. Preliminary results.

A case-control study was conducted in order to test the hypothesis that a reduced exposure to human seminal factors in the early reproductive life of women is a risk factor in breast cancer. The relative risk of exposure to the hypothetical semen-factor deficiency is 4.7 times greater for breast-cancer patients than for the controls. The risk of developing breast cancer within the same population in the U.S.A. is estimated as 5 times greater for women who use barrier methods (condom and other) than for women who use non-barrier contraceptive methods (diaphragm and other). The reduction of the incidence of breast cancer by eliminating the barrier contraceptive techniques would be not less than 50% in married women in the population.

Adult↗
PubMed1995

[Vaginal and intrauterine contraception].

Vaginal contraception (condom, diaphragm and spermicide in pessary, tablet, jelly, cream, or sponge form) have been little used in France and generally in Europe since the advent of modern contraception with "the pill" and the intrauterine contraceptive device. The former methods, when properly used, are nevertheless both effective and useful, at least as interim measures. In addition, the protection they afford against sexually transmitted diseases and, for the condom, against HIV, is not negligible. Finally, the "barrier" methods of contraception such as the diaphragm and the condom afford significant protection against cancer of the cervix. The intrauterine contraceptive device (IUCD), used in France by 14% of women between 15 and 49 years of age and by 90 million women throughout the world for whom it is the main reversible means of contraception, have a mechanism of action that is still not fully understood. Most IUCD now used are made of copper. There are also diffusion IUCD based on progesterone or a synthetic progestational hormone which are useful in case of anaemia, menorrhagia or dysmenorrhea.

Administration, Intravaginal↗
PubMed1985

The cervical cap as a contraceptive alternative.

A recent resurgence in the United States of popular interest in the cervical cap has prompted reexamination of its safety and effectiveness as a contraceptive device. Despite widespread use in Europe, few studies are available for evaluation of this non-hormonal, non-invasive barrier method of contraception. The U.S. Food and Drug Administration classified the cap as a "significant risk device" and has limited dispensing of the cap to providers with Investigational Device Exemptions. Use and fitting of the cervical cap are described.

Contraceptive Devices, Female↗
PubMedDate not supplied

Contraceptive practices of women attending the Sexually Transmitted Disease Clinic in Nashville, Tennessee.

The decision to be sexually active involves two health risks for women: unwanted pregnancy and sexually transmitted diseases. Use of contraception affects both these risks. Data from the Metropolitan Health Department in Nashville, Tennessee, were examined to determine the effects of particular contraceptive methods on gonococcal infection in women. The results suggest that not only barrier methods but also other types of contraception were associated with protection against gonorrhea in females. The use of contraception was unusually high (87%) among the study population of 1,303 women. Five hundred eighteen (40%) of these clinic attendees were infected with Neisseria gonorrhoea. Infected women tended to be younger than those not infected and were significantly more likely to be black than white and somewhat more likely to be single. Contraceptors tended to be younger and were more likely to be black than were noncontraceptors.

Adult↗
PubMed2003

Meeting the reproductive health care needs of adolescents: California's Family Planning Access, Care, and Treatment Program.

PURPOSE: To examine the effect of the California Office of Family Planning's Family Access, Care, and Treatment Program (Family PACT), which was established in 1997 to provide comprehensive, reproductive health services for low-income adolescents and adults. Program evaluation was used to measure access to services, develop a profile of users, identify service utilization patterns, and assess the sensitivity of the health care system to the needs of adolescents. METHODS: Data sources include baseline data on California's previously established family planning services, enrollment, and claims data for the first 4 years of Family PACT, client exit interviews, and on-site observations. RESULTS: Adolescents represented 21% of all clients served by Family PACT in fiscal year 2000-2001 (FY 2000-2001). Adolescent clients served increased from 100,000 in FY 1995-1996 to more than 260,000 in FY 2000-2001(161% increase). The proportion of males has increased from 1% to 11%. In FY 2000-2001, Hispanics comprised 50% of adolescent clients, followed by 32% white, 9% African-American, and 6% Asian, Filipino, or Pacific Islander. Over one-half were aged 18 or 19 years, 42% were aged 15 to 17 years, and 5% were aged younger than 15 years. Contraceptive methods most often dispensed were barrier methods (55% for females, 72% for males), oral contraceptives (44%), contraceptive injections (16%), and emergency contraceptives (7%); 57% received sexually transmitted infection screening. CONCLUSIONS: By linking eligibility determination to the delivery of services, removing cost barriers, increasing the numbers and types of providers offering publicly funded services, and ensuring confidentiality, greater numbers of adolescents obtained needed reproductive health care, thus ensuring an opportunity to reduce unintended pregnancies and sexually transmitted infections.

Adolescent↗
PubMed1987

The role of contraceptive use in cervical cancer: the Maryland Cervical Cancer Case-Control Study.

Recent evidence on the importance of sexual history and sexually transmissible agents in cervical cancer has been reported. Case-control studies have frequently demonstrated increased risk of cervical cancer for women using oral contraceptives, while laboratory results have shown that vaginal spermicides inactivate various sexually transmissible agents. To determine the role of contraceptive use in cervical cancer, 153 cases of Maryland women with invasive cervical cancer and age, race, and residence-matched controls were interviewed in 1985, focusing on sexual history, health care utilization patterns, screening history, contraceptive use, and smoking. Overall, lifetime use of contraceptives was protective of cervical cancer (odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.2-0.7). Use of oral contraceptives (OR = 0.48), diaphragm (OR = 0.29), and vaginal spermicides (OR = 0.28) were more frequent in controls than cases. After adjustment for behavioral factors (age at first intercourse, smoking, gaps in Papanicolaou smear testing, and obstetrician-gynecologist visits), use of vaginal spermicides remained significant (OR = 0.30), although use of oral contraceptives and barrier methods of contraception failed to remain significant. The effectiveness of vaginal spermicides in preventing cervical cancer may be due to their antiviral action.

Adult↗