Use Of Barrier Methods Research Articles

Contraceptive use and method mix dynamics in Sub-saharan Africa: time trends and the influence of the HIV pandemic

BackgroundContraceptive use dynamics continue to be of priority in sub-Saharan Africa because of persistently high levels of fertility. This paper focuses on the use of barrier versus non-barrier contraceptive use in sub-Saharan Africa hypothesizing that the HIV pandemic in the region would be responsible for increases in the use of barrier methods over time.MethodsThis paper uses Demographic and Heath Survey (DHS) data from 32 countries to conduct extensive analysis of trends in contraceptive use and method mix that refers to the distribution of contraceptive methods use among the sexually active population. The paper examines how contraceptive method mix dynamics have changed over time and whether the trends differ by marital status and gender using cross-tabulations. It furthers examines the determinants of method choice using logistic regressions.ResultsThe findings indicate that the use of barrier methods, most markedly for unmarried women and men, rose substantially between the late 1980s and late 2000s in the region in tandem with trends in HIV prevalence. The results further show marked differences in method mix by gender with men being more likely to report barrier method use than women.ConclusionsThe findings indicate shifting preferences in contraceptive choice. The time trend analyses highlight the importance of expanding the focus of contraceptive use studies beyond women in this context as the study finds differing trends for men.Graphical

HIV-related knowledge and risk behaviors among transgender individuals in Dhaka, Bangladesh: A cross-sectional study

The prevalence of human immunodeficiency virus (HIV) among transgender individuals in Bangladesh stands at 1%, with a slightly lower rate of 0.9% observed specifically in Dhaka city. Given their status as a minority group, the limited understanding of HIV among transgender individuals poses a significant public health concern. Consequently, the study aims to investigate the HIV-related knowledge and risk behaviors prevalent among transgender individuals in Dhaka city. This cross-sectional study included 135 transgender individuals sourced from a drop-in-center (DIC) and three selected Hijra Pollis in Dhaka. Data collection employed a semi-structured questionnaire featuring a Likert scale designed to collect data on HIV-related knowledge. The majority of participants identified as professional sex workers, with 54.10% reporting irregular sexual clients, and 48.90% involved in sex work for more than 10 years. Despite more than half (57%) exhibiting robust HIV-related knowledge, only one-third (37.30%) reported sporadic use of barrier methods, and slightly more than half (58%) demonstrated awareness of HIV symptoms. A notable discrepancy in HIV-related knowledge was discerned between transgender individuals from the DIC and their counterparts from the Hijra Pollis (t [95% confidence interval] = 0.168 [0.1001 – 0.236], p < 0.001). In conclusion, despite the provision of healthcare services at the DIC, there persists a pressing need to address current risk behaviors and enhance sex education related to HIV awareness to mitigate associated hazards.

Comprehensive Sexual Health Educational Learning Modules for College Students.

Sexual health education in the United States continues to be a controversial topic of discussion with no federal regulations. Due to this, the sex education students receive before college varies greatly. Our team discovered that no mandatory, comprehensive sexual health education is required for students once they enter the California State University system. At Cal Poly specifically, it was found that students were engaging in risky sexual behaviors. For example, the 2021 American College Health Association-National College Health Assessment III Fall 2021 Data Report revealed that less than half (42.1%) of students reported regularly using condoms during vaginal sex, and a mere 5.1% of students reported barrier method use during oral sex. To fill in the noticed gaps in our students' sexual health education, our team developed a set of 10 comprehensive sexual health educational learning modules. The modules cover topics ranging from condom use and STIs to pleasure, porn literacy, and having difficult conversations with a partner. This anonymous online resource provides students with easy-to-read written material and engaging graphics. Future research will focus on user engagement and the effect of the resource on sexual health best practices across our campus.

Contraception Use by Title X Clients and Clients of Other Providers, 2015–2019

IntroductionTitle X clinics provide access to a wide range of contraceptive options for individuals of all income levels and documentation statuses. As Title X continues to face political uncertainties, it is important to provide up-to-date information about its clients’ use of contraception. This study used recent nationally representative data to compare contraception received by Title X clients with that received by clients of other providers. MethodsThis article draws on 2015–2017 and 2017–2019 waves of the National Survey of Family Growth. The sample was restricted to 15- to 44-year-old women needing contraception. Logistic regressions estimated associations between receiving services at Title X clinics versus at other providers (including private) and use of a range of contraceptive options, as well as number of months’ supply for those using oral contraceptives. ResultsIn 2015–2017, Title X was associated with using any contraception (adjusted odds ratio [AOR], 4.11; p = .004). In both waves, Title X clients were more likely to use long-acting reversible contraceptives (AOR, 1.78 in 2015–2017 [p = .023] and AOR, 2.59 in 2017–2019 [p = .003]) and hormonal methods other than oral contraceptives (AOR, 2.31 in 2015–2017 [p = .007] and AOR, 3.04 in 2017–2019 [p = .001]). In both waves, Title X clients using oral contraceptives were also more likely than non-Title X clients to receive more than a 3-month supply (AOR, 3.54 in 2015–2017 [p = .008] and AOR, 2.61 in 2017–2019 [p = .043]). Title X was not associated in either wave with use of barrier or time-based methods, such as periodic abstinence or withdrawal. ConclusionsPatterns of contraceptive use by Title X clients compared with those of clients of other providers indicate that the Title X program has allowed access to a wide range of contraceptive methods. Ongoing research is necessary to see whether these patterns change over time.

Preconception contraceptive use and miscarriage: prospective cohort study

ObjectivesTo evaluate the association between preconception contraceptive use and miscarriage.DesignProspective cohort study.SettingResidents of the United States of America or Canada, recruited from 2013 until the end of 2022.Participants13 460 female...

Conocimientos y creencias sobre la infección por virus de inmunodeficiencia humana y el sida en mujeres usuarias de métodos anticonceptivos de barrera y naturales: un análisis en zonas urbanas y rurales

Objective: To analyze the knowledge and beliefs about HIV/AIDS in women users of barrier and natural methods in urban and rural areas of Peru. Methods: Cross-sectional analytical study that analyzed the registry of 4926 and 2273 urban and rural women, respectively, who participated in a national survey in 2021. Frequencies and percentages weighted with 95% confidence intervals were estimated; and the chi-square test was calculated with a significance level less than 0.05. Results: In rural areas, the majority of women were users of natural methods (73.6%), while in urban areas, there was less ignorance about HIV/AIDS infection status (11.4%). The proportion of women with inadequate beliefs about HIV was significantly higher in rural areas compared to urban areas (p < 0.001). A higher percentage of barrier method users living in both urban (12.6%) and rural (25.1%) areas were unaware of HIV/AIDS-related issues. Conclusion: In rural areas there is a higher percentage of lack of knowledge and erroneous beliefs about HIV/AIDS. The use of barrier methods was higher in urban areas and natural methods in rural areas. Knowledge and appropriate beliefs were mostly present in users of barrier methods in both rural and urban areas.

The Risk Factors Associated with the Incidence of Genital Warts in Iran

Objective: Prevention of sexually transmitted diseases is an essential factor in managing diseases in the human population and increasing individuals’ and society’s health levels. Thus to increase our insufficient knowledge about proper prevention methods, we performed this study to assess the risk factors of the incidence of genital warts (GW). Methods: In this case-control study, we enrolled 120 women and divided them into two groups. Sixty women with GW were set in the case group, and 60 healthy women were set in the control group. Afterwards, a questionnaire consisting of 13 questions regarding their life habituates was filled. The answers were analyzed using T-tests and chi-square test. Findings: There was a statistically significant correlation between the incidence of GW and age (P-value ≤ 0.001*), the years passed from first intercourse (P-value =0.02*), and the history of venereal diseases (P-value =0.03*). However, the correlation between this disease and smoking, use of contraceptive medications, use of barrier and gravidity methods, marriage, education, the job of the individual and her partner, and the type of intercourse was not statistically significant. Conclusion: It is interesting that although some factors may increase the risk of GW, some factors that one might reason should affect the prevalence of GW such as the use of barriers, marriage, and socioeconomics of the individuals had no significant effect on the prevalence of GW in this study.

Manejo en atención primaria de las infecciones de transmisión sexual (I). Epidemiología. Síndrome secretor

These days sexually transmitted infections (STIs) are important public health problems not only due to their high prevalence, but also because they require early diagnosis and treatment to avoid complications.In recent years, there has been an exponential increase in cases of infections caused by Chlamydia trachomatis and gonococcus in the population under 25years of age. In addition, an increase in the incidence of syphilis and hepatitisC (HCV) has also been detected, especially in men who have sex with other men (MSM).Genital herpes continues to be the second most frequent STI in the world, behind condyloma acuminata, and the first cause of genital ulcer among Spain in the sexually active population.A decrease in reported HIV cases was observed during 2020, but almost half of these new cases had a late diagnosis (<350CD4cell/μL).Current guidelines recommend offering STI annual screening to populations at risk or more often depending on the risk.STIs can appear in the form of syndromes, such as secretory syndrome (urethritis, proctitis, and cervicitis) or ulcerated syndrome (ulcers). The STIs that can cause secretory syndrome are mainly caused by Neisseria gonorrhoeae and C.trachomatis, which co-infect up to 40% of cases, and also cause urethritis, cervicitis or proctitis depending on where they are located.Gonococcus has an incubation period of 2-7days and Chlamydia 2-6weeks, and they are diagnosed using PCR and/or culture (the last one only valid for gonococcus) of samples collected according to sexual activities.Empirical treatment to cover both germs will be accomplished with ceftriaxone, 1g single intramuscular dose plus doxycycline 100mg every 12h orally for 7days, or azithromycin 1g single dose orally (we will use azithromycin only if we suspect a poor compliance with treatment, difficulty in going to the control or in pregnancy).Likewise, whenever we diagnose an STI firstly, we must offer advice and health education in order to promote the adoption of safe sexual behaviours and the correct use of barrier methods. Secondly, we must also screen for other STIs (HIV, syphilis, hepatitisB, and hepatitisA andC depending on the risk), offer HBV and HAV vaccination if it is appropriate, and finally study and treat all sexual partners from the previous 3months.

Causes, Effects and Management of Infertility Among Reproductive Women in Karim Lamido Local Government Area of Taraba State-Nigeria

This study examined the causes, effects and management of infertility among reproductive women in Karim Lamido Local Government Area of Taraba State. Data were collected from the primary source using survey research design. A sample of 385 respondents was drawn and used to represent the entire population of the study. The research instrument was validated and tested using Alpha cronbach with the reliability coefficient of 0.84. Data collected were analyzed using descriptive statistics of frequency, simple percentage, mean and standard deviation. The results showed: endocrine defect, unsafe abortion, excessive use of illegal drugs and Obesity are the main causes of infertility. The study also found that shame and anxiety, psychological problem, divorce and stigmatization are the main effects of infertility among women of reproductive age. Recommendations: Public enlightenment programmes relating to an understanding of infertility, and access to relevant services should be developed as part of reproductive health education to include recognition of infertility (or sub-fertility) as a result of obesity, smoking, delayed childbirth (men and women), increased sexual activity/partners without use of barrier methods, early menopause due to family history, cancer before or during reproductive years, and other factors; infertility services covering a comprehensive range of fertility strategies should be complementary to population policies and programmes of maternal and child health

Understanding how young cisgender heterosexual men navigate sexual health conversations and practices during casual sex: a qualitative study.

Young cisgender heterosexual men in Australia are the least likely population group to undergo testing for sexually transmissible infections (STI) and ensuring barrier method use during casual sex with cisgender women who have sex with men, with rates of STIs increasing among this group. This research examines how these men navigate sexual health conversations and practices during casual sexual encounters. A total of 30 semi-structured interviews with young cisgender heterosexual men living in Australia during 2021 were conducted. Participants were asked questions about their dating and sexual practices, including sexual health knowledge, how they learned to have sex, and navigating sexual health conversations with partners, such as STI testing, and barrier method and hormonal contraceptive use. Findings were analysed using reflexive thematic analysis techniques. Findings note that men use various strategies of avoidance including sustaining the erotic moment, and assuming women's responsibility. Participants also noted limited relationality, in which they highlighted individualised concerns for their own sexual health wellbeing but not that of their partners. This research highlights that despite increased awareness and promotion of STI prevention and contraceptive responsibility, young cisgender heterosexual men continue to forego their responsibilities regarding their own and other's sexual health during casual sexual encounters. Findings highlight a need to include gender transformative approaches to sexual health promotion and practice to address continuing gender inequities.

Characteristics of menstrual cycles with or without intercourse in women with no known subfertility.

Characteristics of menstrual cycles with or without intercourse in women with no known subfertility.

PROGNOSTIC RISK PREDICTORS OF HYPERPLASTIC ENDOMETRIAL PROCESSES IN WOMEN WITH REDUCED REPRODUCTIVE POTENTIAL

In the structure of female infertility, the uterine factor ranges from 25.20% to 42.30%. Inthe structure of gynecological diseases, endometrium hyperplastic processes (EHP) are15-40%, and in women of the reproductive age – 24.0-62.0%.The aim of the research – to examine the risk predictors of the developing benignhyperproliferative pathology of the endometrium in women of the reproductive age toimprove preventive approaches of management of this group of patients.Material and Methods. The results of analytical processing of medical documentationof 860 patients with uterine factor of subfertility, selected by the method of continuoussampling, were presented. For comparison, 100 forms of medical records of somaticallyhealthy patients were analyzed.Results. Dominating infl uences are the following clinical nosologies: endometrialpolyposis and hyperplastic processes (44.19%), adenomyosis (22.33%), multiple uterine fi broids (10.47%), uterine synechia (14.19%). The uterine factor was the main factor interms of reproductive losses and subfertility (38.68%), the incidence of the primary formof infertility was 17.63%, the secondary form (43.68%), the incidence in IVF programswas 119 cases (31.32%), in addition to that 21,85% had poor attempts. Patients rangedin age from 20 to 45 years, and endometrial hyperplasia processes (EHP) were morepronounced in late reproductive age (60.00%) (p &lt;0.05). The risks of EHP developmentin relation to such factors as chronic pelvic infl ammatory disease, adenomyosis andexternal genital endometriosis, hysteromyoma, benign tumors and retention of ovarieshave been determined.Conclusions. The results obtained show an increase in the risk of endometrial hyperplasiaand polyps with age by 2.3 times. There is a high proportion of long-term use of intrauterinesystems, as well as low use of hormonal and barrier methods of contraception, thatcontributed to the chronicity of infl ammatory diseases of the reproductive system. Therisks of EHP development concerning such factors as chronic pelvic infl ammatorydisease, adenomyosis and external genital endometriosis, hysteromyoma, benign tumorsand retention of ovaries were presented. In the analysis of the structure of somaticmorbidity, high share of cardiovascular diseases, thyroid disease and disorders of lipidexchange was revealed. In the group of patients with endometrial hyperplastic processes,a low proportion of pregnancies was noted, along with a high percentage of miscarriages,missed abortions and recurrent miscarriages. The obtained results allow to supplementthe pathogenetic concept of the development of endometrial hyperplastic processes.

Sexual health behavior, health status, and knowledge among queer womxn and trans men in Kenya: An online cross-sectional study.

Little research has been conducted on the sexual health needs and risk behaviors of queer womxn and trans men, making it difficult to identify specific health needs and disparities. This is especially the case in the Global South, where their needs are poorly understood. This study presents findings on demographics, sources of information, sexual (risk) behaviors, and substance use in Kenyan queer womxn and trans men. An online survey among 335 Kenyan queer womxn and trans men was used to collect data on sexual health, risk behavior, health information sources, and substance use. The participants needed to have had at least one self-identified female sexual partner. The sample presented young, highly-educated queer womxn and trans men. A high incidence of childhood sexual trauma found was found. Risk behaviors included sexual activities with partners of multiple genders, violence, and low use of barrier methods. One in three participants had been treated for an STD in the previous year. The incidences of smoking and drinking were high, and a quarter of participants indicated having taken drugs at least once a month or more. The internet was either the first or second most important source of sexual health information for 44.1% of the participants, followed by schools (30.9%). Our findings indicate that queer womxn and trans men are at risk of negative sexual health outcomes due to a lack of appropriate information, risk behavior, substance use, and low uptake of sexual health services. Kenya's Penal Code still criminalizes consensual same-sex activities and may play a role in perpetuating barriers that prohibit them from making healthier choices. Developing tailored programming and policies require local, national, and global stakeholders to engage with the inclusion of queer womxn and trans men's sexual health needs within strategic planning and healthcare delivery.

Prognostic risk predictors of hyperplastic endometrial processes in women with reduced reproductive potential

In the structure of female infertility, the uterine factor occupies one of the leading places and ranges from 25.20% to 42.30%, and in women with repeated unsuccessful attempts at in vitro fertilization, intrauterine pathology is detected in 45% of cases. In the structure of gynecological diseases, hyperplastic processes of the endometrium are 15–40%, and in women of reproductive age – 24.0–62.0%. The objective: to examine the risk predictors of the developing benign hyperproliferative pathology of the endometrium in women of reproductive age to improve preventive approaches of management of this group of patients. Materials and methods. The results of analytical processing of medical documentation of 860 patients with uterine factor of subfertility (pregnant woman’s card (form 111 / y), ambulatory card (form 025 / y-04)), witch were selected by the method of continuous sampling, were presented. This allowed to establish the structure and frequency of endometrial hyperplastic processes in women of reproductive age, to assess the features of reproductive health parameters in this category of patients and to determine prognostic predictors of endometrial hyperplastic processes. For comparison, we analyzed 100 forms of medical records of patients who were routinely preventively examined in these medical institutions. Results. Dominating influences are such clinical nosologies: endometrial polyposis and hyperplastic processes (44.19%), adenomyosis (22.33%), multiple uterine fibroids (10.47%), including submucous myomas (7.79%), uterine synechia (14.19%), uterine retinas and anomalies in the development of the uterus were rarely inserted (2.09% and 1.28% respectively). The uterine factor was the main factor in terms of reproductive losses and subfertility (38.68%), the incidence of the primary form of infertility was 17.63%, the secondary form (43.68%), the incidence in IVF programs was 119 cases (31.32%), including one in five failed IVF attempts (21.85%). Patients ranged in age from 20 to 45 years, and endometrial hyperplasia and polyposis were more pronounced in late reproductive age (60.00%) versus (40.00%) in early reproductive age, respectively (p&lt;0.05). The performed statistical calculations allowed to present the risks of developing hyperplastic processes of the endometrium in relation to such factors as chronic pelvic inflammatory disease (OR = 6.16; 95% CI: 3.52–10.78), adenomyosis and external genital endometriosis (OR=10,59; 95%: 4.21–26.67), uterine fibroids (OR=3.07; 95%: 1.19–7.92), benign tumors and retention of ovaries (OR=4.98; 95%: 1.96–1.67). It should be noted that the share of somatic disorders and their comorbidity increased with age by 1.7 times in cases of hypertension, metabolic disorders, thyroid pathology and diseases of the urinary system (p&lt;0.05). Assessing the reproductive function in women with endometrial hyperplastic processes, it should be noted the low reproductive potential in this category of patients. Conclusions. The results show an increase in the risk of endometrial hyperplasia and polyps with age by 2.3 times. There is a high proportion of long-term use of intrauterine systems, as well as a low use of hormonal and barrier methods of contraception, which, no doubt, can contribute to the chronicity of inflammatory diseases of the reproductive system. The statistical calculations allowed to present the risks of developing hyperplastic endometrial processes for such factors as chronic pelvic inflammatory disease, adenomyosis and external genital endometriosis, uterine fibroids, benign tumors and retention of ovaries. In the analysis of the structure of somatic morbidity, the share of cardiovascular diseases, thyroid disease and disorders of fat metabolism is high. In the group of patients with endometrial hyperplastic processes, a low proportion of pregnancies was noted, along with a high percentage of miscarriages, missed abortions and recurrent miscarriages. The obtained results allow to supplement the pathogenetic concept of the development of endometrial hyperplastic processes.

“Pattern of Sexually Transmitted Infections: Treated in A Private Clinic at Dhaka, Bangladesh”

Background: Sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), continue to present major health, social, and economic problems in the developing world, leading to considerable morbidity, mortality, stigma and long-term disability, economic loss and death throughout the world. Despite the availability of effective treatment and preventive measures, incidence of STIs is increasing even in developed countries. Objectives: To determine the pattern of sexually transmitted infections in patients presenting with genital symptoms. Material and Methods: A cross sectional, descriptive study was carried in the Dermatology-Venereology Clinic of Holy Lab Diagnostic &amp; Consultation Centre, Uttara, Dhaka, Bangladesh from January to December 2019. During one year period, a total of 140 consecutive cases were enrolled in this study. The diagnosis of infections was made clinically with relevant laboratory investigations and they were interviewed for their sexual behaviour after taking consent and assuring confidentiality. Results: A total of one hundred forty (140) patients who presented with genital symptoms were studied. The average age of this population was 28.84 years (±9.15) and it ranged from 18-58 years. 3.7% belonged to age group 18-27 years, followed by 28-37 years (22.1%); 38-47 yrs (52.8%); 48-57 yrs (18.5%) and &gt; 57 yrs (2.8%). Majority patients of 38-47 yrs 74 cases 52.8%. Males outnumbered females, constituting 76.2% of the total patients, with male to female ratio of 3.37:1. Out of the total 140, some had multiple complaints while others were asymptomatic. Majority cases of burning micturition in both male and female patients 39(24%). Burning micturition and discharge from genitalia was also observed in both sexes. The most frequently encountered infection in both male and female was Gonococcal Urethritis (GU) 42 (30%). The infections were common among both married and unmarried people. Other group of people who had no STI (23.5%) was suffering from venereophobia, pearly penile papules and some form of dermatitis. No case of HIV infection was encountered in this study. Gonococcal Urethritis was common mainly among businessman, transportation worker, security personnel and housewives. Other infections were equally dispersed in all other occupation groups. Conclusions: The prevention and control of STI is based on health education, appropriate diagnosis and treatment. Sexually active people adolescents and young adults should be provided with proper sex education about delaying sex debut and protective measures (correct and consistent use of barrier method during every sexual act) to prevent these infections with especial focus on monogamous relationship.

Obstacles and enablers for the use of barrier methods to avoid HIV/AIDS transmission

There is an increase in HIV/AIDS transmission rates world-wide Aim: To explore obstacles and facilitators in the use of barrier methods for the prevention of HIV/AIDS among Chilean young people between 20 and 29 years of age. During the second semester of the year 2020, 134 young Chileans answered an online questionnaire with open-ended questions about barrier methods. A qualitative methodology that considered the main techniques of grounded theory for data analysis was used. There are individual, interpersonal, sociocultural, and structural factors that operate as obstacles and facilitators for the use of barrier methods to prevent the transmission of HIV/AIDS. There are culturally embedded beliefs among young people, such as, a perception of invulnerability caused by not being part of risk groups, among others, that affect self-care.

Sexual practices of women who have sex with women and condom use

Objective: to analyze the sexual practice of women who have sex with women and its association with condom use. Methods: correlational study involving 231 women who have sex with women, recruited through electronic application (Instagram and WhatsApp). A questionnaire was applied through Google Forms, containing sociodemographic data, sexual history, and the types of sexual practices. Results: most women performed oral sex (86.4%) and manual sex (86.9%) without using condoms. A large proportion (84.8%) reported the use of fomites in sexual practices without condoms. The inexistence of a fixed partnership (p=0.000) and the performance of sex with vaginal contact (p=0.013) were associated with sexual intercourse without condoms. Conclusion: the sexual practice of women who have sex with women points to greater vulnerability to sexually transmitted infections, by practicing oral and vaginal sex with manual practices without the use of barrier methods.

The renaissance of barrier contraception (based on the data from an international clinical trial)

Background. In recent years, interest in the use of barrier methods of contraception has increased, since many women prefer them in connection with the change in the epidemiological situation associated with COVID-19, with contraindications to other methods of contraception, as well as with irregular sex life and casual sexual intercourse. In addition, these methods of contraception are preferred for breastfeeding mothers and pre- and postmenopausal women. Studies of the efficacy of spermicidal agents in late reproductive age women have not previously been carried out, although their use in this population is of particular interest, since these agents do not have a systemic effect and, if used correctly, can prevent unwanted pregnancies. The article presents data from an international French-Russian study of the efficacy of spermicides containing benzalkonium chloride in late reproductive age women (over 40 years). The study was carried out on the basis of 7 private offices of obstetricians and gynecologists in France and 6 obstetric and gynecological clinics in Russia.&#x0D; Aim. Assessment of the contraceptive efficacy, safety and acceptability of a cream containing benzalkonium chloride in women over 40 years of age.&#x0D; Materials and methods. The study included non-pregnant women aged 40 and over who had at least 1 menstrual period in the past 3 months and who would like to use spermicides as contraception for at least 6 months. After a 6-month period of mandatory use of spermicide, patients could, if desired, continue to use it for the next 6 months. All women were given Pharmatex (1.2%), a vaginal cream containing benzalkonium chloride (1.2 g per 100 g of cream) as the active ingredient, 1 standard dose before each intercourse. The primary endpoint was the Pearl Index. The acceptability of the method after each use of the cream, the moisturizing effect, and the woman's and researcher's overall satisfaction with this method of contraception were also assessed. Safety was assessed using adverse event monitoring.&#x0D; Results. An analysis of efficacy of the study drug showed that during study, pregnancy did not occur in any of the women. Pearl Index for 12 months was 0. Over the mandatory 6-month period, the use of Pharmatex cream was assessed by patients as acceptable (to some extent acceptable, acceptable, completely acceptable) in 98% of sexual intercourse, and over the 12-month period in 98.6% of intercourse. The moisturizing effect of the cream was noted by 96.1% of women. In 6 months of the use of Pharmatex cream, overall satisfaction was rated as quite good, good, or very good by 99.3% of patients and in 12 months by 100% of patients. Adverse events were noted only in 0.5% of cases. Most of these events were assessed as unrelated to the study drug.&#x0D; Conclusion. The use of a benzalkonium chloride spermicidal cream can be considered an effective and acceptable method of contraception for women over the age of 40. It is well tolerated, has a moisturizing effect on the vaginal mucosa, and meets the needs and lifestyle of women. The contraceptive with benzalkonium chloride has a favorable safety profile: it does not adversely affect the normal flora of the vagina, can be used during breastfeeding, since it does not penetrate into the vascular bed and doesnt have systemic effects.

A rise in births following contraceptive failure in France between 2010 and 2016: results from the French national perinatal surveys

BackgroundIn France, while the prevalence of contraception is high, a significant proportion of pregnancies are unintended. Following the 2012 pill scare, the contraceptive method mix, which was mostly comprised of pills and intrauterine devices (IUD), has become more diversified. In this changing landscape, our objective was to describe trends in live births resulting from contraceptive failure and evaluate how patterns of contraceptive use have contributed to observed changes between 2010 and 2016.MethodsWe used data from the 2010 and the 2016 French National Perinatal surveys which included all births from all maternity units in France over a one-week period. Interviews collecting information about pre-conception contraceptive practices were conducted in the maternity ward post-delivery. Women were classified as having a contraceptive failure if they discontinued contraception because they were pregnant. Our study sample included adult women who had a live birth, had ever used contraception and did not undergo infertility treatment (n = 11,590 in 2010 and n = 9703 in 2016). We evaluated changes in contraceptive failure over time using multivariate Poisson regressions to adjust for sociodemographic characteristics and pre-pregnancy contraceptive methods.ResultsPre-pregnancy contraception evolved between 2010 and 2016 with a 12.3% point-drop in pill use, and conversely, 4.6%- and 3.2%-point increases in IUD and condom use, respectively. Use of other barrier or natural methods doubled between 2010 and 2016 but remained marginal (1.4% in 2010 vs 3.6% in 2016). Between 2010 and 2016, the proportion of live births resulting from contraceptive failure rose from 7.8 to 10.0%, with higher risks among younger, parous and socially disadvantaged mothers. The risk ratio of contraceptive failure in 2016 compared to 2010 remained higher after sociodemographic adjustments (aRR = 1.34; 95% CI; 1.23–1.47) and after adjusting for pre-pregnancy contraceptive method mix (aRR = 1.35; 95% CI; 1.25–1.49). Increases in contraceptive failures were concentrated among pill and condom users.ConclusionsRecent shifts in contraceptive behaviors in France following the 2012 pill scare may be associated with a subsequent increase in births resulting from short acting contraceptives failures.

Preliminary Results of a Screening Programme for Chlamydia in an Asymptomatic Young Population in Spain.

Introduction: Chlamydia trachomatis (CT) infection has increased in recent years, reaching 127 million cases in 2016. Possible complications, especially among women, require intervention for early detection of the infection. The objective of our study was to determine the prevalence of CT infection in a young, sexually active, asymptomatic population.Methods: A cross-sectional study was conducted between December 2017 and 31 December 2018 among young patients aged 18–25 years attending the emergency room for any reason. The presence of CT and other STIs in urine was determined by the Allplex Nucleic Acid Amplification Test (NAAT) with a urine sample. All patients testing positive were followed by the STD unit and tests on all sexual partners/contacts were offered. Moreover, we obtained data about sexual habits and risk factors via a self-reporting questionnaire.Results: One thousand three hundred eight patients were eligible for inclusion of whom 298 consented to participate. Of these, 22/298 (7.4%) were diagnosed with CT. Young people with two or more sexual partners in the last month and those suffering from infection by ureaplasma were at greater risk of infection by CT. Up to 50% of participants do not use barrier methods.Conclusion: The prevalence of infection by CT in the asymptomatic young population is higher than expected according to the recent literature in Spain. The scarce use of barrier methods among this population may be one of the causes of this increase and one of the targets to work on in order to reduce the prevalence of the infection.