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At least 19 recordsLinked to original sources
PubMed1993

Prevention of sexually transmitted infections. Physical and chemical barrier methods.

Barrier contraceptives, including mechanical methods, chemical methods, and combinations thereof, have the potential to decrease the spread of STDs, are inexpensive, and do not have any systemic effects. Currently, the concerns that the efficacy of latex condoms is limited because they are not consistently used, they can break, may cause allergies, and have a limited shelf-life has led to the development of condoms made of other materials such as polyurethane. Spermicides using nonoxynol-9 as their active ingredient have been shown to be effective in preventing the transmission of some STDs such as gonorrhea and chlamydia. In the absence of well-controlled studies of nonoxynol-9 efficacy against HIV, questions have been raised that some formulations, high doses, or frequent use may be associated with genital tract irritation, and possibly, enhancement of HIV transmission. Because heterosexual transmission will continue to be the major route of HIV transmission worldwide, the development and consistent use of a chemical or mechanical barrier during intercourse may be the best way to decrease the spread of HIV.

Condoms↗
PubMed2000

Barrier methods of contraception.

Despite the problems associated with coitus-dependent methods of contraception, barrier methods have an important role. The fact that they work as contraceptives without systemic effects makes them particularly appropriate for women with medical conditions that prevent the use of hormonal contraception. In addition, condoms and perhaps all barrier methods provide protection from sexually transmitted infections, making them essential for sexually active women at risk for STDs. Their continued importance is evidenced by the ongoing research to develop and improve barrier methods of contraception.

Condoms↗
PubMed2000

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↗
PubMed1982

The prevention of postoperative pelvic adhesions: an animal study comparing barrier methods with dextran 70.

There are two major approaches to the prophylaxis for adhesions: chemical methods (e.g., dextran) and barrier methods. Theoretically, dextran prevents the formation of adhesions by a surface-coating or hydroflotation effect, whereas the barrier methods either prevent the formation of or mask adhesions by covering and isolating the injured area with an inert substance. This study compared the efficacy of two different concentrations of dextran 70 and various barriers in preventing the formation of adhesions in the female rabbit pelvis. Symmetrical cut and scrape lesions were made on both sides of each rabbit's uterus; for the barrier-treated animals, the lesions on one side were covered with a barrier, and the contralateral side served as a control. The barriers tested were: Gelfilm, Surgicel, Silastic, Gelfoam paste, amnion, peritoneum, and omentum (five rabbits per subgroup). The same cut and scrape lesions were induced in 16 additional rabbits in the chemical group. These rabbits were subsequently treated with 10 ml/kg of intraperitoneal 6% dextran 70 (five rabbits), and 32% dextran 70 (five rabbits), and were compared with six external control rabbits. The severity of the adhesions that formed was graded by a numerical scoring system. The barrier methods tested resulted, generally, in an increased formation of adhesions when a comparison was made with control and with dextran-treated animals. The degree of formation of adhesions in the dextran-treated rabbits did not differ from that in the control animals. The data suggest that the barrier methods actually promote the formation of adhesions whereas the findings with dextran 70 were inconclusive.

Amnion↗
PubMed2006

Satisfaction among women: differences between current users of barrier (male condom) and non-barrier methods.

OBJECTIVES: To determine the differences in and factors related to satisfaction between barrier (male condom) and non-barrier method users. METHODS: A semi-structured questionnaire was used for collecting data for this cross-sectional survey. The questionnaires were completed via one-on-one interviews by the researchers. The study group was selected using stratified random sampling. Exclusion criteria were, being unmarried, pregnant, in postmenopausal status and using traditional methods. A total of 434 currently married women using modern contraceptive methods participated in the study. Contraceptive users were dichotomized into two groups as non-barrier method users and barrier method users. RESULTS: About half of the participants (n = 191, 44%) were barrier method users. Their mean age was 33.7 +/- 7.3 years, 66.6% (n = 131) were well educated and reported significantly less pregnancies, given births, living children and abortions (reproductive history events) than non-barrier users. Barrier method users were significantly more likely to be satisfied with their contraceptive method of choice (OR: 2.4; 95% CI 1.2-5.2). Among barrier method users, deciding the type of the contraceptive method themselves had significant effect on satisfaction. CONCLUSION: In our study, satisfaction was mostly affected by heavy side effects and health risks of the methods resulting in less satisfaction with the contraceptive method among non-barrier method users. Other factors which may influence satisfaction deserve further investigation.

Adult↗
PubMed1998

Increasing barrier method use among oral contraceptive users at risk of STDs. What approach is best?

OBJECTIVES: We evaluated whether offering a choice of barrier methods can increase overall barrier method use without decreasing condom use in women using oral contraceptives (OCs) for contraception. STUDY DESIGN: We randomized 167 OC users at risk for sexually transmitted diseases (STDs) into two groups, one receiving male latex condoms only (Condom group), the other receiving both male latex condoms and nonoxynol-9 film (Choice group). All participants received similar hierarchical STD protection counseling. We assessed method use with daily diaries. RESULTS: The Choice group protected a significantly higher percentage of their coital acts with a barrier method (month 1 to 2: 29% vs. 22%; month 3 to 4: 33% vs. 21%; and month 5 to 6: 35% vs. 19%; adjusted P = 0.012). Condom use in the Choice group was higher as well (adjusted P = 0.036). When we used a transitional multilogistic regression approach to account for differential loss to follow-up in the two groups, results were similar. CONCLUSIONS: Offering a choice of barrier methods increased overall barrier method use without decreasing condom use.

Adult↗
PubMed1996

Factors affecting the consistent use of barrier methods of contraception.

OBJECTIVES: To discuss the major issues involved in the consistent and effective use of barrier methods of contraception. DATA SOURCES: Major research and review articles on barrier methods published within the last 10 years were considered. One major source of articles was Family Planning Perspectives. METHODS OF STUDY SELECTION: This paper is a focused review and integration of recent literature rather than a comprehensive literature review. Only selected articles published since 1986 that are pertinent to the issues raised are included. TABULATION, INTEGRATION, AND RESULTS: All barrier methods have common characteristics that influence their patterns of use. The correct and consistent use of such methods is determined by the complex interaction of characteristics of the methods themselves, characteristics of users, and the situational context. Method characteristics include the extent of interference with sexual spontaneity and enjoyment, the amount of partner cooperation required, and the ability of the method to protect against human immunodeficiency virus and other sexually transmitted diseases. User characteristics include motivation to avoid unintended pregnancy, ability to plan, comfort with sexuality, and previous contraceptive use. Stage of sexual career, relationship characteristics, and physical and sexual abuse are important situational influences. CONCLUSIONS: Even though most barrier methods can be obtained without a prescription from a provider, clinicians have an extremely important role in promoting effective and consistent method use. Four major ways to improve the use of barrier methods currently available include: 1) improve method characteristics and the distribution systems; 2) change consumers' perceptions of method attributes; 3) train consumers to use methods correctly and overcome-perceived negative characteristics of the methods; and 4) change values about the perceived importance of method characteristics. There also is an urgent need for the development of better barrier methods.

Adolescent↗
PubMed1982

Barrier-method contraceptives and pelvic inflammatory disease.

The protective effect of barrier-method contraception against pelvic inflammatory disease (PID) was examined by analyzing data from the Women's Health Study, a large multicenter case-control study. We compared the contraceptive methods used by 645 women hospitalized for initial episodes of PID with the contraceptive methods used by 2,509 control subjects reporting no history of PID. The risk of hospitalization for PID in women currently using barrier methods relative to women using all other methods and to women using no method of contraception was 0.6 (95% confidence limits, 0.5 to 0.9) for both comparisons. This protective effect was observed for both chemical and mechanical barrier methods, although it was not statistically significant for the former. The prevention of PID and its sequelae is one of the most important noncontraceptive benefits of barrier methods of contraception.

Adolescent↗
PubMed1995

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↗
PubMedDate not supplied

Natural family planning with and without barrier method use in the fertile phase: efficacy in relation to sexual behavior: a German prospective long-term study.

A large prospective long-term study with users of natural family planning (NFP) methods has been conducted to analyze the relation between unintended pregnancy rates and sexual behavior with special reference to barrier method use in the fertile phase. Seven hundred and fifty eight NFP beginners, 19-45 years of age, 14870 cycles, 28 unintended pregnancies were studied. Of the couples, 54.2% use NFP only or predominantly and 45.9% use mixed methods (additional barrier method use in the fertile phase in 55.7% of the cycles). The overall pregnancy rate after 12 cycles of exposure is 2.2% according to the actuarial method. There is no significant difference between NFP users and mixed methods users and also no significant effect of duration of use in the first 5 years of exposure. During "perfect use" the pregnancy rate at 12 months is 0.63%. When only protected intercourse takes place in the fertile phase the pregnancy rate is 0.45%. The symptothermal method of NFP is most unforgiving for imperfect use (unprotected intercourse in the fertile phase). However, it is extremely effective when either abstinence or protected intercourse is used in the fertile phase.

Adult↗
PubMed2005

Effectiveness of female controlled barrier methods in preventing sexually transmitted infections and HIV: current evidence and future research directions.

OBJECTIVES: To evaluate evidence for the effectiveness of female controlled physical and chemical barrier methods in preventing STI/HIV transmission, to examine recent reviews on microbicide development, and to highlight promising research directions. To discuss challenges in conducting effectiveness research and in translating results to public health intervention. METHODS: Systematic review of articles that examined the disease prevention effectiveness of at least one female controlled barrier method. Review of conference abstracts that presented clinical and preclinical microbicide data. RESULTS: Randomised controlled trials provide evidence that female condoms confer as much protection from STIs as male condoms. Observational studies suggest that the diaphragm protects against STI pathogens. Several microbicide effectiveness studies are under way and new directions, such as adaptation of therapeutic agents as preventive products, are being examined. Substantial attention is now given to product formulation and novel delivery strategies. Combining microbicide products with different mechanisms of action as well as combining chemical and physical barriers will be necessary to maximise prevention effectiveness. CONCLUSIONS: Increased investment in the development and identification of female controlled barrier methods offers promise that additional products will be available in the years ahead. Generalizing trial results to a community setting, promoting products that may be less effective than male condoms, and bringing an effective product to scale introduce public health challenges that warrant attention. The need for female controlled barrier methods that provide women with the opportunity to take an active role in reducing their STI/HIV risk are urgently needed and constitute an essential tool to prevent continued spread of these infections.

Adolescent↗
PubMed1992

Barrier methods of contraception and cervical intraepithelial neoplasia.

This North Carolina-based case-control study examined risk factors for cervical intraepithelial neoplasia (CIN). Cases were 103 women with biopsy-confirmed CIN II or III who were recruited from a referral dysplasia clinic. Controls were 258 family practice patients with normal cervical cytology. All subjects were interviewed regarding their sexual and reproductive history, Pap smear screening, active and passive cigarette exposures, and contraceptive use patterns. When compared with controls, cases were half as likely to have ever used barrier methods of contraception; the adjusted odds ratio was 0.5 (95% CI 0.2-0.9). The risk of CIN II/III decreased further with increasing years of barrier method use. Recency, latency, and age at first barrier method use were all associated with a reduced risk of CIN. Men and women should carefully consider the range of benefits of barrier method use as a means to reduce their risk of unwanted pregnancies, sexually transmitted diseases, and cervical neoplasia.

Adult↗
PubMedDate not supplied

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↗
PubMed1989

Barrier methods of contraception and the risk of cervical neoplasia.

The relationship between the use of barrier contraception methods and the risk of cervical neoplasia was analyzed using data from a case-control study conducted in the greater Milan area, northern Italy. A total of 367 cases of invasive cancer under 60 years of age were compared with 323 subjects in hospital for acute conditions unrelated to any of the established or suspected risk factors for cervical cancer, and 316 cases of cervical intraepithelial neoplasia were compared with 258 outpatient controls. Ever-use of barrier methods (condom and diaphragm) was reported by 6% of the cases of invasive cancer and 12% of hospital controls. Corresponding values for intraepithelial neoplasia were 16% for cases and 22% for outpatient controls. Considering the total use of barrier methods, compared to never use, the relative risk of invasive cervical cancer was 0.4 (95% confidence interval 0.2-0.9) and decreased with duration of use (chi 2(1), trend = 5.18, p = 0.02). Likewise, use of barrier methods lowered the risk of intraepithelial neoplasia; the estimated relative risks were 0.9 in users for less than two years and 0.6 for two or more (chi 2(1), trend = 4.61, p = 0.03). Although the protection for invasive cancer appeared to be greater at older ages and in multiparous women, the relative risks were not significantly heterogeneous in various strata of parity, number of sexual partners, oral contraceptive use and history of Pap smears.

Adolescent↗
PubMed2001

Awareness and use of untested barrier methods by HIV-seropositive gay and bisexual men.

Little is known about HIV-seropositive men's awareness and use of untested barrier methods during anal intercourse. A sample of 240 HIV-seropositive men (69.2% men of color) completed a self-administered survey that included items on nonoxynol-9 (N-9), female condoms, and the simultaneous use of two male condoms (double bagging). Most participants (79.6%) had heard of N-9 being used to prevent HIV transmission during anal intercourse. Of these, 20.0% rated N-9 as more effective than condoms, and 14.6% had used N-9 instead of condoms. Fewer men (35.4%) were aware of female condoms being used during anal intercourse. Overall, few respondents (5.4%) had used female condoms; 53.8% of whom rated the device as more pleasurable than male condoms. Most men (69.6%) had heard of double bagging, and 35.2% had engaged in this practice. Of these, 45.1% rated the practice as less pleasurable than using a single condom. Few associations were observed between participant characteristics and the awareness or use of these barrier methods. The widespread use of these untested methods emphasizes the urgent need to further educate HIV-seropositive men about the potential risks of N-9 use and to test the effectiveness of other strategies that may serve as alternatives to male condom use.

Bisexuality↗
PubMed2001

Hormonal and barrier methods of contraception, oncogenic human papillomaviruses, and cervical squamous intraepithelial lesion development.

We assessed the influence of hormonal (oral, injectable, or levonorgestrel [Norplant, Wyeth-Ayerst, Philadelphia, PA]) and barrier methods of contraception on the risk of cervical squamous intraepithelial lesions (SIL), while adjusting for high-risk (HR) HPV infection. Subjects were women receiving family planning services through the state health department clinics from 1995 to 1998. We selected 60 cases with high-grade cervical/SIL (HSIL) and 316 with low-grade cervical/SIL (LSIL) and controls (427 women with normal cervical cytology) and analyzed cervical DNA for HR-HPV, using Hybrid Capture I (Digene; Gaithersburg, MD). When assessing ever use, duration, recency, latency, and age at first use, neither oral contraceptives (OC), Norplant, nor injectable use was associated with an increased risk of SIL development after adjusting for age, age at first sexual intercourse, and HR-HPV positivity. Among HR-HPV-positive women, longer duration barrier method use was associated with a reduced risk of SIL. This finding has important clinical implications for SIL prevention among HR-HPV-infected women.

Adolescent↗
PubMed1989

The vaginal contraceptive diaphragm and the condom--a reevaluation and comparison of two barrier methods with the rhythm method.

The use-effectiveness and continuation rates of two barrier methods of contraception, the diaphragm and condom, were studied during a two-year follow-up in a group of 85 and 98 women, respectively. All were highly motivated. Results were compared to a group of 64 women using the periodic abstinence or rhythm method, i.e. not using any contraceptive. The patients selected the method of contraception they preferred and were instructed in their proper use. Results showed good continuation rates in the groups using a diaphragm and the condom for 2 years, for a total follow-up of 5570 cycles. Pregnancy rate after 24 months of use, as calculated by Pearl's formula, was 2.48 for the diaphragm, 3.21 for the condom, and 5.19 in the rhythm group. No serious side effects or complications occurred in either group. The study demonstrated a fair acceptability and use-effectiveness for barrier contraceptive. We suggest that these harmless and complication-free methods may still be reasonable alternatives for the "modern" methods, the pill and the IUD.

Adolescent↗
PubMedDate not supplied

Comparative contraceptive efficacy of the female condom and other barrier methods.

Because the research design for the clinical trial establishing the contraceptive efficacy of the female condom--a six-month life-table probability of failure of 15% (12% in the United States vs. 22% in Latin America)--did not include randomization with another method of contraception, no definite conclusion about its comparative efficacy is possible. Comparisons using other female barrier methods as historical controls, however, provide evidence that, among women in the United States, the contraceptive efficacy of the female condom during typical use is not significantly different from that of the diaphragm, the sponge or the cervical cap. The six-month probability of failure during perfect use of the female condom is 2.6% among U.S. women, similar to rates for the diaphragm and the cervical cap but significantly lower than that for the sponge. Meaningful comparisons with the male condom are not possible because of the lack of data from carefully controlled prospective clinical trials. Extrapolations from the results on contraceptive efficacy suggest that perfect use of the female condom may reduce the annual risk of acquiring the human immunodeficiency virus by more than 90% among women who have intercourse twice weekly with an infected male.

Clinical Trials as Topic↗