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PubMed1991

Barrier contraceptives, spermicides, and periodic abstinence.

Although barrier contraceptives were among the first methods of preventing unwanted pregnancy ever described for human use, with the advent of the non-coitally related oral contraceptives and intrauterine devices, they gradually fell into relative disuse. However, for a variety of reasons, this is no longer the case. There is a renewed interest in these techniques both as a major form of birth control and also as our best protection against the transmission of sexually transmitted diseases, many of which are now occurring in epidemic form. This latter reason has stimulated fresh approaches to both physical barriers and spermicidal agents. In addition, attempts have also been made to assess the true effectiveness of periodic abstinence and ways in which to make its use more accurate and acceptable.

Contraceptive Devices↗
PubMed1990

Inter-relationships between HIV infection and other sexually transmitted diseases.

The HIV is a typical sexually transmitted disease (STD) agent which depends for its transmission through sex on contact between raw body tissues of infected and uninfected individuals independent of sexual inclination. The dynamics of HIV transmission and its control in a community can be inferred from studying the socio-cultural and epidemiological aspects of acute STD. There is strong evidence to suggest that the main cause of rampant heterosexual transmission of the HIV in sub-Saharan Africa in contrast to the rarer heterosexual HIV transmission in Europe and the USA is the high prevalence of ulcerative STD in Africa. Studying the trend and response to treatment of conventional acute STD are quick and indirect ways of assessing the impact of control measures against AIDS and HIV infection in an HIV endemic area. Further research is needed to determine the extent and detailed mechanism of interaction between HIV infection and other STDs as well as studying the efficacy of AIDS control through control of other STDs.

Africa↗
PubMed1984

The significance of finding curved rods in the vaginal secretions of patients attending a genito-urinary medical clinic.

Curved rods were found in 108 (21.6%) of 500 women consecutively attending a genito-urinary medical clinic. A positive association was elicited with the wearing of an intra-uterine contraceptive device (p less than 0.001), intercourse with a casual or multiple sexual partners within the preceding 3 months (p less than 0.001) and concurrent chlamydial infection of the uterine cervix (p less than 0.025). There was no apparent relationship with contact with non-candidal balanitis, but an increased rate (31.3%) was noted in contacts of non-gonococcal urethritis indicating a need for further research into a possible aetiological role.

Bacteria, Anaerobic↗
PubMed1983

Alternative causes of pelvic inflammatory disease.

Seminal fluid from asymptomatic men reveals a wide variety of aerobic and anaerobic bacteria. The number of bacteria tends to correlate with the sexual experience of the individual. Experimental evidence has shown that these bacteria can attach themselves to moving spermatozoa and travel through ovulatory-phase cervical mucus. Exogenously added bacteria also exhibit the same potential. These experimental results suggest a rational explanation for the development of pelvic inflammatory disease in promiscuous women with multiple sexual partners. In addition, the findings help to explain the marked difference observed in the rate of pelvic inflammatory disease among patients using barrier-type birth control and oral contraceptives as compared with the rate among women who use intrauterine devices, with which the ovulatory-phase cervical mucus is unprotected.

Adolescent↗
PubMed1993

Condom knowledge, attitudes and use among patients attending the public STD clinic in Singapore.

Three hundred patients (255 males and 45 females) attending the public STD clinic in Singapore were interviewed regarding their frequency of condom use, attitudes towards condoms, problems related to condom use and places of purchase of the condoms. Among respondents with regular partners, 55.2% of males and 48.8% of females never used condoms, only 12.4% of males and 16.3% of females used condoms consistently. Among respondents with non-regular partners, only 2.2% of males used condoms consistently. The commonest reasons why male respondents did not use condoms consistently were that condoms decreased sensation, condoms made sex mechanical, the use of other forms of contraception, no condoms were available, and the perception that there was no risk of contracting STD/AIDS. Condoms were most commonly obtained from sex partners, supermarkets, roadside sundry shops and the Maternal & Child Health Clinics (MCHCs). About 8% of both males and females had experienced some problems with condoms before. Greater efforts to promote the practice of protected intercourse among the STD patient population as well as in the general population are required in order to control the spread of STD and AIDS in Singapore.

Adult↗
PubMed1996

Low prevalence of human immunodeficiency virus type-1 (HIV-1) infection in population attending a major hospital in New Delhi, India.

During 4 year period between April 1990 and March 1994, 4120 specimens from the patients attending out patient departments of Medical, Surgical and Antenatal units of a major city hospital were tested for HIV infection as a part of an on-going sentinel surveillance programme. In addition, 1440 specimens from the patients attending STD clinic of the same hospital and 862 females seeking termination of pregnancy from a near by hospital were included for comparison. It was found that only 3 individuals with high risk behaviours out of 2002 females attending antenatal clinic showed evidence of HIV infection (rate 1.49 per 1000). The corresponding rate for the group of patients attending STD clinic and seeking termination of pregnancy were 3 out of 1440 (rate 2.15 per 1000) and 1 out of 862 (rate 1.16 per 1000) respectively. It was noted that prevalence of HIV infection in the hospital attending population with unspecified risk factor (medical, surgical and antenatal clinics) was not a matter of serious concern. The importance of finding out risk factors in females attending antenatal clinic is evident from the study.

Adolescent↗
PubMed1995

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↗
PubMedDate not supplied

HIV infection and AIDS.

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Acquired Immunodeficiency Syndrome↗