"At a time when AIDS has become a devastating public health problem, therole of female barrier methods to prevent sexually transmitted diseaseshas taken on new importance."

This article discusses several studies that examine human behavioral factors that affect barrier method use -- how and why women use barrier methods, what they like or do not like about these devices, how partner attitudes are likely to influence use, and the gap between acceptability and use.

"For some women, barrier methods are messy, inconvenient, uncomfortable and costly. For others, barrier method use is complicated by cultural norms that discourage couples from talking about sexual matters, including contraception. And for many women, successful use of female barrier methods frequently depends upon the cooperation of their male partners.

Male latex condoms offer the best protection against STDs, including HIV, and are more effective contraceptives than other barrier methods. Many couples, however, do not use condoms, believing they reduce sexual pleasure or that condoms are used only with casual partners or prostitutes."

Female condom appeal

"Women like the female condom because it can be woman-initiated and many report increased sexual pleasure for both the woman and man compared with the male condom. For these and other reasons, some users prefer it to the male condom." Based on studies in Zimbabwe, Costa Rica, Thailand and Kenya, and Brasil, the majority of women preferred the female condom but "partner approval is critical for successful use of the female condom and other female barrier methods".

Diaphragm and spermicides

"A study in Colombia, Turkey and the Philippines found that among 550 diaphragm users, some women liked this method because it was free from side effects, while others said it gave them more control over their contraceptive use. 'I like it because I can manipulate it,' said one woman. 'I do not need to ask my husband. I am responsible.' They also were more likely to have used a contraceptive method previously and were more likely to be dissatisfied with intrauterine devices (IUDs) or hormonal methods, such as oral contraceptives and injectables.

However, partner attitude was important. While continuation rates were comparable to those of IUDs and hormonal contraceptives, women who reported their partners were unaware of method use or who liked the method were almost three times more likely to continue than other women."

New methods

"In working with the Population Council to develop a microbicide, the Women's Health Advocates on Microbicides (WHAM) suggested that researchers explore multiple formulations to meet women's diverse needs -- microbicides in gels, films, foams or sponges; microbicides with or without applicators; microbicides with and without contraceptive effects; and microbicides with or without a prescription. WHAM members said that a desirable microbicide would be one that was effective, not messy and could be inserted several hours before sex."

The article concludes that although new technologies will help to reduce women's vulnerability, they must be implemented in conjunction with promoting partner communication among users so that barrier methods can be used effectively.

Click here for the article in English.

Click here for the article in French.

Click here for the article in Spanish.