Contraception - Condoms

STI prevention
Certain types of condoms provide some protection
against sexually transmitted infections, in addition to
contraception. All condom materials do not provide
the same protection. Animal-based condoms do not
protect against HIV. However, latex products offer
good if not perfect protection against HIV. To a lesser
extent they reduce the risk of gonorrhea, syphilis,
chlamydia, chancroid, trichomoniasis, HPV, herpes,
and pelvic inflammatory disease.
Cervical cancer effect
Condoms decrease the risk of cervical cancer by as
much as 50%, probably because of their impact on
sexually transmitted infections such as HPV.
Efficacy
The addition of spermicidal products increases their
efficacy. Products that impair latex integrity should be
avoided, see Table 7.6. Non-latex condoms, generally
polyurethane, became available in 1995. They may
provide less contraceptive efficacy, primarily due to
increased breakage, but are acceptable alternatives for
those with allergies, sensitivities or preferences that
might prevent the use of latex condoms.28
Lubricants that are compatible with condoms are
listed in Table 7.7.
Female condoms were FDA approved in 1993.
The most common has two flexible rings on each
end of a polyurethane sheath. One ring inserts into
the vagina similarly to a diaphragm; the other end
remains on the vulva. Female condoms should be
removed immediately following intercourse and
before standing. In laboratory studies, HIV transmission
has been prevented but there are no clinical
studies available. One study in Africa has suggested that use of female condoms, in addition to male
condoms, by women with husbands with AIDS may
further reduce the transmission rate.29 Latex sensitivity
is not an issue, because they are not made of latex.
Therefore, oil-based products can be used. Compared
with male condoms, the female condom breaks
less frequently, slips more and is not as effective
in pregnancy prevention. Experience improved results
for both.30
Clinicians should strongly consider discussing the
availability of EC with condom users because
condoms can break (1/70), slip (5/70), leak (3.5 to
7/70), and be used inconsistently. Some couples also
report less sexual sensitivity and latex-sensitive individuals
cannot use latex condoms.

Posted in: Contraception,Health