RESUMO
Over the past 20 years, the number of women in the United States choosing a cervical barrier contraceptive method has dramatically declined. By 2002, fewer than 3% of women reported using any woman-initiated barrier method, including the diaphragm, female condom, or cervical cap. At the same time, however, research in infectious diseases indicates that cervical barriers may effectively prevent the transmission of several sexually transmitted infection. This possibility has fueled the recent development of two novel devices. This article examines the seven devices currently available in the United States, comparing their characteristics, efficacy, benefits, and drawbacks. Compared to the diaphragm, the new devices do not offer improved odds of pregnancy prevention, and evidence for their efficacy is sparse. Reasons for the limited acceptance of these methods as contraceptives on one hand-and for interest in their potential for limiting sexually transmitted infections on the other-will also be reviewed. Despite the limited acceptance of cervical barrier methods, midwives and other clinicians should promote their availability as an alternative to other reversible contraceptives.
Assuntos
Método de Barreira Anticoncepção/métodos , Anticoncepcionais Femininos/normas , Dispositivos Anticoncepcionais Femininos/normas , Sexo Seguro , Saúde da Mulher , Método de Barreira Anticoncepção/normas , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Infecções Sexualmente Transmissíveis/prevenção & controle , Estados UnidosRESUMO
We apply an extension of a statistical model developed in the fertility research setting to the barrier contraceptive trial setting to obtain estimates of the probability of pregnancy per cycle day in the presence or absence of barrier use among participants of a randomised trial of female barrier contraceptives. The per cycle day pregnancy curve for the barrier trial participants was similar to previously published results from a fertility study that included a precise indicator of ovulation day. In addition, our analysis showed strong contraceptive effects for the diaphragm. The proposed modelling approach should allow evaluation of the effects of other coitus-specific exposures on the chance of pregnancy in other prospective studies, including fertility studies.
