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Barrier methods should be part of the method mix in all family planning/reproductive health (FP/RH) clinics. The advantages of barrier methods, such as sexually transmitted disease (STD) protection, should be emphasized to providers and clients, as well as the importance of correct and consistent use to achieve pregnancy protection. Barrier methods provide less protection against pregnancy and STDs with typical use.
Barrier methods should be presented to clients equally with other methods, allowing the client to choose the method most suitable for him or her.
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Many users of FP are at risk of contracting STDs including human immunodeficiecny virus (HIV), yet are unable to avoid their risky sexual encounters and so need preventive methods. Barrier methods are the only class of FP methods that protect users against STDs. A second reason that barrier methods are important is that some people in need of FP are not medically eligible to use, or unwilling to use, hormonal methods, intrauterine devices (IUDs), natural family planning or surgical contraception.
Yet anecdotal evidence points to provider bias against barrier methods. Providers may perceive barriers to be ineffective; they may also worry about the time required for client education, motivation and fitting (in the case of the diaphragm and cervical cap).
While the typical effectiveness of barrier methods is indeed less than that of hormonal methods and IUDs, for consistent and correct users, barrier method effectiveness is quite high. Although some barrier methods do require more time with new acceptors, the potential benefits of STD prevention, and communication with sexual partners are considerable.
- Cervical cap: effective, convenient, but overlooked. Contraceptive Technology Update 1990;11:49-54.
- Trussell J, Sturgen K, Strickler J, Dominik R. Comparative contraceptive efficacy of the female condom and other barrier methods. Family Planning Perspectives 1994;26:66-72.
- Norsigian J. Feminist perspective on barrier use. In: Mauck CK, Cordero M, Gabelnick HL, Spieler JM, Rivera R (editors). Barrier contraceptives: current status and future prospects. New York: Wiley-Liss, 1994.
- Feldblum P, Joanis C. Modern barrier methods: effective contraception and disease prevention. Research Triangle Park, NC: Family Health International, 1994.
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