Barrier Methods How Barrier Methods Work Barrier Methods Create a Barrier, Either Physical Or Chemical, That Prevents Sperm from Reaching the Egg
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Barrier Methods How Barrier Methods Work Barrier methods create a barrier, either physical or chemical, that prevents sperm from reaching the egg. Condoms, diaphragms and cervical caps are physical barriers. Spermicides are chemical barriers and are delivered using foam, cream, jelly, film, suppositories or tablets. male condom Barrier methods are the only contraceptives recommended for STD prevention. spermicides Prevention of Sexually Transmitted Disease Bacterial Viral STDs Method STDs (including HIV) female diaphragm Male condom yes yes condom Female condom* cervical cap Spermicides (N-9) Diaphragm with spermicides yes under study Cervical cap* * confimred by laboratory studies only General Characteristics of Barrier Methods Strengths Weaknesses • effective at preventing pregnancy and some STDs • not as effective for pregnancy prevention as when used consistently and correctly other methods in typical use • safe • can be difficult to use consistently and correctly • no systemic effects • may require partner participation • easy to initiate or discontinue • may interrupt sexual activity • immediate return to fertility • cultural barriers may inhibit use • most do not require a clinic visit • need for proper storage and resupply • expensive in some settings Considerations for Potential Users Effective Counseling for Barrier Methods Good Candidates for Barrier Method Use It is important to help clients to prioritize between pregnancy Women or men who: prevention and disease prevention. Some clients may choose • are at increased STD risk dual method use. Counseling elements include: • cannot or do not want to use hormonal methods • strengths/weaknesses/side effects • need a backup method of contraception • how to use the method correctly • have sex infrequently, especially young adults • importance of consistent use • want a method that is user-controlled • suggestions on how to negotiate use with partner • how to make it a part of sexual activities (where Who Should Not Use Barrier Methods appropriate) General: • common problems in • usually not recommended in cases of allergy to latex or use (and spermicides solutions) Diaphragm and Cervical Cap: • where to get • not recommended for women resupply - with cervical or vaginal anatomical abnormalities • use of - during first six weeks after childbirth emergency • usually not recommended for women: contraception, - with history of toxic shock syndrome where available Artwork adapted from PATH and The Population Council. Male Condom Female Condom The male condom is the only method recommended for The female condom is a female-controlled method made of prevention of all STDs, including HIV, and is safe for almost plastic. It can be inserted into vagina prior to initiation of everyone. However, condom use may interrupt sexual activity sexual activity and prevents the transmission of bacterial and and may reduce sensation. Latex condoms can be damaged by possibly viral STDs. However, it may be difficult to learn to exposure to heat, light or humidity. insert and may be expensive. Correct Use Correct Use • unroll to base of erect penis before • avoid genital contact genital contact before it is in place and • hold onto condom and remove penis after removing from vagina while still erect • inner ring is inserted Behaviors Likely to Cause Breakage high in the vagina, and Slippage Artwork adapted from PATH and WHO. covering the cervix • outer ring is placed • opening package with teeth or sharp objects Artwork adapted from Wisconsin Pharmacal. • unrolling condom before putting it on outside of the vagina • prolonged or vigorous intercourse • using oil-based lubricants Diaphragm and Cervical Cap • reusing condom The diaphragm and cervical cap must be fitted by a trained health-care provider. They can be inserted up to six hours prior Most condom breakage is due to to intercourse. They must be properly cleaned and stored for human error or incorrect use, reuse. Diaphragms provide some not manufacturing defects. protection against cervical infections, but may cause increased urinary tract infections. The cervical cap may be less effective in parous women. Spermicides Spermicides prevent transmission of gonorrhea and chlamydia. Correct Use They can be stored for long periods of time. They may be • must be left in place six hours messy, cause mild discomfort or minor allergic reaction, and can after intercourse; can be left up lead to yeast infections. They also may cause vaginal irritation to 24 hours (diaphragm) or up to with frequent use. 48 hours (cap) • additional spermicide needed Correct Use for diaphragm for each act of • use clean hands and clean applicator for insertion intercourse; no additional • follow package directions carefully spermicide needed for cap • place high in the vagina against cervix • for maximum effectiveness, use with another barrier Follow-up Issues method; use for each act of intercourse • may need refitting if a woman has weight change, or after a • no douching for six hours after last act of intercourse full-term pregnancy or 2nd or 3rd term abortion • should be refitted if a woman complains of discomfort • if necessary, give instructions on management of urinary tract infections Barrier Methods — Essential for Reproductive Health Barrier Methods Are Available through The following actions are important to help protect reproductive health: • family planning clinics • screen for STD risk and provide information on preventing STDs • community-based distribution programs • provide counseling for changing high-risk sexual behavior • STD clinics • promote and distribute condoms through a variety of approaches, • youth programs including: • private/commercial sector - social marketing programs using advertising, promotion and Barrier methods can be used as part of a other commercial marketing techniques ‘’dual-method” approach: use of one - community-based distribution method highly effective at pregnancy prevention, • through direct services or referral, provide STD with a barrier method, usually condom, management services: diagnosis, treatment, and partner for disease prevention. notification and treatment • ensure proper storage and supply.