Abstract

PIP: Nonhormonal methods of contraception--including condoms, spermicides, withdrawal, the diaphragm, periodic abstinence, and the IUD--are again increasing in popularity and accounted for 42% of contraceptive use in 1987. Most dramatic have been increases in condom and spermicide use due to the ability of these methods to serve as physical and chemical barriers to the transmission of the human immunodeficiency virus and other sexually transmitted diseases. The cervical cap, approved for distribution in the US in 1988, offers several advantages over the vaginal diaphragm, including a wear time of up to 48 hours, reduction in the amount of spermicide required, and small size. Although acceptance of periodic abstinence has not kept pace with recent increases in contraceptive prevalence, more than 10% of married women in some developing countries adhere to natural family planning. Moreover, new technologies identifying the fertile period have made this method more reliable and thus more acceptable. The Copper T-380A IUD, with a pregnancy rate of less than 1 per 100 women the 1st year of use, is expected to attract growing numbers of acceptors, especially given recent research findings of a lack of effect on pelvic inflammatory disease incidence and subsequent fertility. In fact, the World Health Organization has cited the IUD as the single most effective reversible method of fertility control. Contributing to increased prevalence rates for barrier methods is the trend toward a dual method of contraception (i.e., oral contraceptive is association with condoms) among women at risk of sexually transmitted diseases.