Use Of Barrier Methods Research Articles

Sexual behavior of adolescent students in Chandigarh and their perceptions regarding family life education.

Background:With rapidly changing lifestyle and exposure to the Internet and mass media, lifestyle and sexual behavior of adolescent students are also changing rapidly.Objectives:To investigate the sexual behavior of adolescent students and to study misconceptions prevailing among them.Methods:A cross-sectional survey of 1022 adolescent students aged 14–19 years as a part of an Indian Council of Medical Research sponsored survey. Sexual behavior explored by interview method. Logistic regression analysis for finding correlates.Results:Intimate friendship was reported by 19.2% respondents. The sexual behavior included 89% exposure to sex-related material, 74.7% were aware of sexual intercourse. Awareness regarding at least one contraceptive was found among 95.5% (94.5% of condoms and 67.2% of emergency contraception). About 6% respondents reported some sex-related problems and 2.5% of all respondents consulted some doctors for these problems. Awareness of HIV/AIDS was quite high (about 99%), and 96.4% of them were of the opinion that it is spread through sexual intercourse. Knowledge regarding transmission of sexually transmitted infections (STIs) through sexual contact was found among 89.2% respondents. Avoidance/abstinence from sex (84.7%), faithful to one partner (81.7), and use of barrier methods (90.3%) was main reported preventive measures for STI's. About 33% want that the discussion about sex should be open and frank, and 69.4% showed the need of sex education in the schools mostly by doctors.Conclusions:Sexual behavior of adolescent students is changing, and awareness about sex acts is also increasing. There is likelihood of indulging in risky behavior by adolescents. Family life education was felt necessary mainly by qualified medical staff.

Use and Effectiveness of Barrier and Spermicidal Contraceptive Methods

Use and Effectiveness of Barrier and Spermicidal Contraceptive Methods

The current prevalence of Chlamydia trachomatis infection among teenagers and young asymptomatic Chilean women justifies the periodic surveillance

Chlamydia trachomatis infection constitutes the most common sexual transmitted disease (STD) among young women. International studies demonstrate that prevalence changes over time and also according to places. To estimate the prevalence of this infection among asymptomatic Chilean women (15 to 24 years old) and correlating with risk factor occurrence. Transversal cohort study to identify C. trachomatis infection through a diagnostic kit designed to detect and amplify cryptic plasmid DNA by quantitative PCR from endocervical sample. 181 women were screened during the period of study. The overall prevalence estimate was 5.5% and founding significant estimate variations (0% to 14.6%) between recruiting centers. There was difference in number of sexual partners (4.1 vs 2.5; p<0.05) between positive and negative women. No difference was observed in age of first coitus, STD history, the use of barrier method or socioeconomic level. However, the probability of being carrier increases as greater is the number of sexual partners, especially when the use of barrier method is low. The latest is not related to the socioeconomic level. One of 12 to 18 women at this age range will have asymptomatic infection. The current prevalence and its variability substantiates the C. trachomatis screening and periodic surveillance.

"This Method, I Think, Can Shed New Light": Haitian-American Women's Reflections on Risk, Culture, and Family Planning Decisions From a Short-Term Trial of a Cervical Barrier (Femcap™).

Improving the reproductive health of immigrant populations requires understanding the specific context of risk and need. As part of a field trial of the FemCap™, a woman-initiated cervical barrier contraceptive, we conducted postintervention focus group discussions (FGDs) with 20 women (five FGDs) of Haitian background, the majority of whom were born in Haiti and spoke Haitian Créole at home, at a community health center in south Florida. Participants discussed the role of religion and inequitable gender norms in Haitian traditions about family planning decisions and provided important insights into the gender-power nuances of their partnership dynamics vis à vis the use of female barrier methods. Encouraged by more equitable gender norms in the United States, participants were eager to serve as health education agents, with strong altruistic sentiments toward other Haitian girls and women who they felt could be encouraged to negotiate for greater reproductive decision-making power.

Beating the Spread: Developing a Simulation Analog for Contagious Body Fluids.

Effective models simulating the spread of contagion from provider to other patients, visitors, and rooms in a physically simulated emergency department setting have not been reported, and the effect of personal protective equipment (PPE) on reducing such spread in a simulated emergency department environment has not been quantified. We developed a physical model for the spread of an Ebola-like virus. The scenario involved 3 computerized mannequins. One case was a febrile patient after Ebola exposure. Four residents (group A) had only masks and gloves and were initially unaware of exposure history, whereas 4 residents (group C) had known exposure history and had full PPE present in the room. Infected mannequins and surrounding surfaces were coated with Glo Germ, a UV tracer. Fluorescence to UV light was recorded after each scenario. Both tracer groups were compared with a control group (group B) in which no tracer was used to account for background fluorescence. There was transfer of contagion to providers, other patients, nurse and family member confederates, and other treatment rooms. Half of group C used full PPE, and half used partial PPE. There were 3 contaminations in group C with full PPE use, 15 contaminations in group C with partial PPE, and 65 contaminations in group A. The UV tracer seems to be a useful analog of contaminated bodily fluids because it spread easily and its spread decreased with the use of barrier methods. This model could be used in future studies to measure the effectiveness of different forms of PPE and to study the effectiveness of provider education on appropriately donning and doffing PPE.

Understanding Female Condom Use and Negotiation Among Young Women in Cape Town, South Africa.

In most countries, female condoms are not widely available and uptake has been slow. More information is needed on how women and men successfully negotiate female condom use. In-depth interviews were conducted at two sites in Cape Town, South Africa, with 14 women and 13 men who had used female condoms. A structured interview guide was used to elicit information on how women negotiate female condom use, and how male partners negotiate or respond to negotiations of female condom use. Thematic analysis was used to identify key patterns in the data. Participants reported that female condoms are easier for women to negotiate than male condoms, largely because the method is understood to be under a woman's control. The main barrier to use was lack of familiarity with the method; strong negative reactions from partners were not a major barrier. Personal comfort and tensions with partners usually improved after first use. Some male respondents preferred the method because it shifts responsibility for condom use from men to women. Findings suggest that female condoms empower women to initiate barrier method use, and that programs designed to educate potential users about female condoms and familiarize them with the method may be useful. That some men preferred female condoms because they wanted women to take responsibility for condom use is cause for concern, and suggests that counseling efforts should be directed toward men as well as women, and should include a discussion of gender dynamics and responsibility that emphasizes condom use as a choice that couples make together.

Contraception for Adolescents: Focusing on Long-Acting Reversible Contraceptives (LARC) to Improve Reproductive Health Outcomes.

Adolescent pregnancy rates in the U.S. have reached an all-time low from their peak in the 1980s and 1990s. However, the U.S. maintains the highest rate of teenage pregnancy among developed nations. Adolescents experience higher typical use failure rates for user-dependent contraceptives compared to their adult counterparts. Long-acting reversible contraception (LARC), IUDs and implants, have failure rates that are both very low and independent of user age. In settings where the most effective methods are prioritized and access barriers are removed, the majority of adolescents initiate LARC. Use of LARC by adolescents significantly reduces rates of overall and repeat teen pregnancy. All methods of contraception are safe for use in teens, including IUDs and DMPA. Dual use of LARC and barrier methods to reduce risk of sexually transmitted infection, is the optimal contraceptive strategy for most adolescents. Adolescent access to evidence-based and confidential contraceptive services, provided in a manner that respects autonomy, is a vital public health goal.

Oral Manifestation of Secondary Syphilis in a Patient With The Human Immunodeficiency Virus: Case Report

Infective syphilis is caused by the anaerobic alimentary spirochete, Treponema pallidum. The changing epidemiology of syphilis reflects the falling use of barrier methods of contraception, high numbers of sexual partners, and sexual promiscuity. Man, 30, had several patches in the dorsum of the tongue that appeared over about 2 weeks. Clinical examination revealed multiple rounded red areas with a loss of tongue papillae. His medical history did not include human immunodeficiency virus (HIV) infection, but he smokes and drinks socially.

Use of Condoms among Human Immunodeficiency Virus Positive Women Attending Antenatal Clinic in Nnewi, South East Nigeria.

Background:Consistent use of condom provides protection from transmission of human immunodeficiency virus (HIV) infection in couples with sero-discordant HIV status. It also protects against acquiring other strains in HIV positive concordant couples.Aim:This study evaluated the use of barrier method of contraception among HIV patients.Subjects and Methods:This was a descriptive cross-sectional study conducted among pregnant women in Nnamdi Azikiwe University Teaching Hospital Nnewi. An interviewer administered questionnaire was used to obtain relevant information from the subjects. Data was analyzed using SPSS software version 20.0 (Chicago, IL, USA, August 2011).Result:A total of 126 HIV positive pregnant women participated in this study. The mean age of the women was 30.4 (5) years while the mean parity was 2.6 (1). All the patients had at least primary education with 63.5% (80/126) having secondary education as the highest educational attainment while 87.3% (110/126) were in monogamous marriage. The partner's HIV status showed that 41.3% (52/126) tested negative to HIV antibodies while 42.8% (54/126) tested positive to HIV antibodies and 15.9% (20/126) do not know partner's HIV status. Only 61.9% (78/126) of the couples use condom during sexual intercourse. Further analysis showed that 26.2% (33/126) use condom consistently except during timed intercourse for conception. There was significant association between type of relationship and use of barrier method of contraception. There was no significant association between sero-discordant couples and highest educational status with use of barrier method of conception.Conclusion:Condom use among HIV positive couples is low and raises great concern on transmission of the virus to partners and babies born to positive mothers.

A single-arm study to evaluate the efficacy, safety and acceptability of pericoital oral contraception with levonorgestrel

BackgroundAn oral dose of 0.75 mg levonorgestrel (LNG) taken shortly after sex was marketed as a routine, nonemergency contraceptive method until the 1990s. Because a hormonal method used only at the time of intercourse may be desirable for women who have infrequent sex, we conducted a study to reevaluate the potential of pericoital LNG as a primary means of contraception. MethodsWe enrolled women aged 18–45 years in Brazil and the USA who expected to have sex 1–4 days per month for 6.5 months. Participants were instructed to take one tablet 0.75 mg LNG within 24 h before or after sex, with no more than one dose in any 24-h period. The primary efficacy measure was the Pearl Index among women aged 18–35 years. ResultsThe study was stopped after 72 of the planned 300 participants were enrolled due to slow recruitment and related feasibility considerations. In the primary analysis, three pregnancies occurred during 13.4 woman-years of follow-up, resulting in a Pearl Index of 22.4 (95% confidence interval, 4.6–65.4). No serious adverse events were reported, and vaginal bleeding patterns were generally acceptable. ConclusionsOur estimated Pearl Index was noticeably higher than expected from previous research of LNG for pericoital contraception. Although the regimen was safe and generally acceptable, the study was challenged by slow enrollment and curtailed person-years of follow-up, resulting in poor precision for the estimated treatment effect. Future research may inform whether our results are symptomatic of the regimen, study design or characteristics of the populations from which we recruited. ImplicationsOur study failed to confirm prior data suggesting that 0.75 mg LNG for pericoital contraception could be more effective than typical use of barrier methods among women having infrequent sex. Characterizing populations most likely to adhere to, and benefit from, pericoital regimens is essential to future research on these methods.

English

BACKGROUND: This study was carried out in department of obstetrics and gynaecology G.R. Medical College Gwalior (MP). AIMS AND OBJECTIVES: To study the incidence of malignant and pre malignant cases of cancer cervix in women attending outdoor patient department of G R medical college Gwalior. To find out the role of PAP's smear in early detection of premalignant and early carcinoma cervix and to compare the results between urban and rural women. MATERIAL AND METHOD: a total of 400 subjects were selected attending outdoor patient department of G R medical college Gwalior with equal number of urban and rural areas. Information about age, parity, age at marriage, complaints, clinical findings, Pap's smears were prepared and histological interpretations were recorded. RESULTS: Maximum number of patients was in the age group of 31- 40 years. Mean age at marriage was 17.5 years for woman of rural areas and that for urban woman was 21.5 years. In the rural patients highest number were P2-P4 (53%) followed by > P4 (46.5%). In urban patients too maximum number of patients had parity between P2-P4 (69.5%) followed by > P4 (28.5%). Grand multiparity was seen in 20.5% among rural women as compared to 1.5 % among urban women. Among the rural patients use of barrier method of contraception was only 12% while in urban areas it was 30%. Percentage of couples who were not using any contraception was 47.5% in rural area and 33% in urban area. The most common presenting complaint was white discharge among both rural and urban groups (75% vs. 72%). The most common clinical finding was cervical erosion (57.5%) Histopathological interpretation of Pap's smear revealed cervical squamous epithelial lesions (LSIL and HSIL) in 10.5% smears of rural and 4.5% smears of urban women. A total of 4% smears were found positive for malignancy in rural women as compared to 1.5% smears in urban women.

Dual Use of Long-Acting Reversible Contraceptives and Condoms Among Adolescents

Unintended pregnancy and sexually transmitted infections (STI) continue to be significant public health problems, and adolescents are disproportionately affected by both. With national attention and funding directed toward adolescent pregnancy prevention, promotion of long-acting reversible contraceptive (LARC) use among adolescents is both timely and relevant. However, LARCs provide no protection against STIs, requiring dual-method use of both LARC and barrier methods, most commonly the male latex condom, to address these issues simultaneously. Rates of both LARC and dual-method contraception are low in the United States, but have increased in recent years. Dual-method contraception is highest among younger women and adolescents with multiple or new sex partners. Consistent condom use remains a major barrier to dual-method use, as it necessitates admission of STI risk by both partners, and use is dependent upon two decision-makers rather than a single contraceptive user. Promoting the initiation and maintenance of LARC and condom use across multiple partnered sexual encounters requires understanding of individual, dyadic, and social influences. Successful maintenance of contraceptive and STI prevention behaviors requires individualized, longitudinal reinforcement, and social supports, but can ultimately reduce the burden of unintended pregnancy and STI among adolescents.

Protecting pediatric oncology patients from influenza.

Influenza is a common respiratory pathogen. Its severity can be unpredictable, but people with chronic illness are at increased risk of severe infection, complications, and death from influenza. This review examines evidence to support various strategies to protect pediatric oncology patients from influenza-related morbidity. Influenza vaccination should be considered standard. Additional evidence-supported measures include antiviral treatment, antiviral prophylaxis, cohorting of patients, and hospital infection control measures. Data from other high-risk populations support the vaccination of family members, double-dose or high-dose vaccination, and the use of barrier methods. These measures have the potential to optimize patient outcomes because there will be fewer treatment interruptions for acute illness. These strategies can also protect patients from prolonged hospitalizations and morbidity related to influenza.

Risk of Hepatitis among Undergraduates attending Primary Health Care Facility in Uyo

Sexuality encompasses sexual intercourse and sexual contact in all its forms, as well as medical concerns about the physiological or even psychological aspects of sexual behavior. Aim of the study was to observe the relationship between sexuality, drug use and hepatitis infection among university students. The study involved distribution of questionnaires and informed consent forms to 200 volunteer undergraduates after ethical approval was obtained from Primary Health Care Center, Uyo. The filled questionnaires were returned and blood samples were collected from the volunteers for hepatitis A and B screening tests. The result showed that the majority (69.3%) of the volunteer undergraduates were in their penultimate and final year of study. More than half (58.2%) of the volunteer students have had sexual intercourse with one (69.39%) or more than one (7.14%) sex partners with the use of barrier method in most (91.23%) of the study population that had sexual activity while few (8.77%) failed to use barrier method. Rate of sexual activity varies among the volunteer undergraduates as once daily (4.08%), once weekly (17.35%), twice weekly (5.10%) and abstinence (22.45%). Among the volunteer undergraduates, few (19.4%) had viral hepatitis screening while majority (80.6%) had no awareness until the research study commenced. One unaware volunteer participant (1.28%) was detected to be positive to viral hepatitis B infection. The study population which has 21 to 25 years, female (57.1%) and single (86.8%) were most actively involved in sexual activity. They lack substantial knowledge of the risk of being infected with viral hepatitis. The study population also reflected the indiscriminate use of drugs among students. In conclusion, students are involved in risky sexual activity and indiscriminate use of nonprescription drugs that can lead to hepatitis infection and also its spread. Most of the students lack knowledge of hepatitis infection.

Misperceptions regarding protective barrier method use for safer sex among African-American women who have sex with women

Barrier methods for HIV and sexually transmissible infection (STI) prevention among women who have sex with women (WSW) are available, although their effectiveness has not been systematically investigated. These methods are infrequently used by WSW. As part of a larger study on STI risk perceptions and safer sex among African-American WSW, we discovered several misperceptions regarding barrier methods that may be associated with their limited use. Participants were recruited from the Jefferson County Health Department STI Clinic and through word of mouth in Birmingham, Alabama, for focus group discussions exploring perceptions of STI risk and safer sex. Seven focus groups with 29 participants were conducted (age range: 19-43 years). Several misperceptions regarding barrier methods were identified, notably the conflation of dental dams and female condoms. Descriptions of the use of barrier methods were qualified with phrases suggesting their hypothetical, rather than actual, use. Additional evidence that barrier methods are not actually used came from beliefs that dental dams and female condoms are available in major grocery stores or department store chains. Those providing sexual health services to WSW should be cautious in assuming that WSW have accurate information regarding barrier methods for safer sex. Sexual health services provided to WSW should include an accurate description of what barrier methods are, how to distinguish them from barrier methods more commonly used during heterosexual sex (female and male condoms), and how to use them correctly. Future studies are needed to address how effectively these measures reduce transmission of STIs among WSW.

Basic body knowledge in street-recruited, active drug-using women enrolled in a “body empowerment” intervention trial

Background: Drug-using women remain at high risk for HIV infection. Female condoms (FC) have proven potential and cervical barriers have promise to reduce HIV risk; their effective use may be boosted by familiarity and confidence about female anatomy. Women with high levels of crack cocaine use were assessed for their knowledge about reproductive anatomy, HIV/STI risk, as well as cancer screening behaviors.Methods: Women were recruited for a randomized trial of a behavioral intervention via mobile vans in Philadelphia known for high crack use and sex exchange. Knowledge and behavioral data on 198 women were collected via interviewer-administered questionnaire. Women were randomized into control (n=99) and intervention (n=99) arms. Five weekly, small-group, intervention sessions stressed “body empowerment” and teaching use of female-initiated barrier methods. Follow-up body knowledge data were collected at 12 months. Changes in and correlates of body knowledge were analyzed and compared.Results: Most participants were African-American (66%); their mean age was 39.6 years. At baseline, 44% of the sample erroneously believed women have sex and urinate from the same place; 62% erroneously believed that tampons could get lost in the abdominal cavity. Only 27% knew douching increased STI transmission risk; only 10% knew condoms reduce cervical cancer risk. At follow-up, overall body knowledge improved substantially, across both arms. Race was associated with high body knowledge at baseline but not at follow-up.Conclusions: Knowledge favoring use of women-initiated methods and cervical cancer prevention was very low in this hard-to-reach sample. Body knowledge improved substantially with enhanced voluntary counseling and testing (VCT) as well as the women-focused intervention. Body knowledge education must be targeted and tailored to drug-using women.

Trends in Contraceptive Use among Florida Women: Implications for Policies and Programs

Our study objective was to assess changes in effective contraceptive use among women at risk of unintended pregnancy in Florida in 2008 and 2009 compared with 2002 and 2004. Contraceptive use questions were available from Florida's Behavioral Risk Factor Surveillance System (BRFSS) for both periods (n=4,606). Log binomial regression was used with appropriate methods to account for complex sampling in the BRFSS. We examined the change in four effective contraceptive use groups: sterilization, long-acting reversible contraceptive (LARC), short-acting reversible contraceptive (SARC), and barrier methods. Prevalence ratios comparing the two time periods were adjusted by demographic characteristics, employment, insurance status, children at home, poverty level, health behaviors, and health status. No evidence of change was found in sterilization (Adjusted Prevalence Ratio APR=0.96; 95% CI: 0.84-1.10) or SARC (APR=1.01; 95% CI: 0.87-1.18). The overall use of LARC increased and use of barrier methods decreased significantly over the two periods (APR=1.68; 95% CI: 1.09-2.60 and APR=0.77; 95% CI: 0.61-0.98, respectively). Only two population groups experienced significant changes in prevalence in the four use groups over this period. Non-Hispanic White women increased their use of LARC (APR=2.89; 95% CI: 1.58-5.29) and women who have never been married decreased their use of barrier methods (APR=0.51; 95% CI: 0.33-0.77). Contraceptive use in Florida continues to be low overall with some shift towards more effective long-term methods. New efforts are needed to promote and increase family planning practices, which include the use of effective contraceptives.

Male and female public opinion regarding a possible male contraceptive pill

Reversible male contraception (RMC) is currently limited to the use of barrier methods. A non-hormonal, oral method of RMC is currently on the cusp of clinical trial. Differences in the attitudes and beliefs between men and women towards a RMC have not been examined.

Gregorio Millett: an improbable journey

Gregorio Millett: an improbable journey

Men who have sex with men: stigma and discrimination

The first cases of AIDS were identified in gay men in the USA, and the disease was originally termed gay-related immune deficiency (GRID). Mobilisation of attention and resources was slow, partly because of the association between AIDS and male homosexuality and corresponding reluctance on the part of government officials to acknowledge the importance of the epidemic. 25 years later, the same reluctance is evident in many parts of the world, and again, scarcity in attention and resources is affecting responses to HIV transmission in homosexual men. 1 Beyrer C Baral SD van Griensven F et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012; (published online July 20.)http://dx.doi.org/10.1016/S0140-6736(12)60821-6 Google Scholar The complex relation between homosexuality and HIV continues to mark the epidemic, even in countries where most infections are unrelated to homosexual contact. 2 Dowsett G The ‘gay plague’ revisited. in: Herdt GH Moral panics, sex panics. New York University Press, New York2009: 130-156 Google Scholar That most societies regard homosexuality with a mixture of disdain and disgust has therefore been, and remains, a major factor in the development of the epidemic. 3 Parker R Aggleton P HIV and AIDS-related stigma and discrimination. Soc Sci Med. 2003; 57: 13-24 Crossref PubMed Scopus (1648) Google Scholar The cultural challenge of HIV/AIDSAs the HIV epidemic enters its fourth decade, HIV transmission in several parts of the world shows no sign of abating—for example, in sub-Saharan Africa an estimated 1·9 million people became newly infected in 2010.1 Certain affected populations in the epidemic are more marginalised than others, notably gay men and other men who have sex with men. A biologically heightened vulnerability to HIV and the limited uptake and use of barrier methods, especially among younger cohorts of men who have sex with men, fuelled by stigma and in some parts of the world criminalisation, makes addressing the issue of HIV/AIDS in men who have sex with men complex, as this Lancet Series shows. Full-Text PDF