Contraception and STDs
Rosenberg, M.
Ippf Medical Bulletin 25(5): 3-4
1991
ISSN/ISBN: 0019-0357 PMID: 12284650 Document Number: 316445
Since behavioral research indicates that assumption of less risky sexual practices is unlikely, prevention of sexually transmitted diseases (STDs) by alteration in contraceptive practice is more realistic. Condoms, known from laboratory tests to be impermeable to semen, body fluids, and all STD organisms except hepatitis B fragments, only reduce transmission of most STD infections by 50% in actual use. Those who use condoms more consistently achieve better protection, while condom failure due to breakage is concentrated among some users. Spermicides, including nonoxynol-0, benzalkonium chloride, menfegol, and octoxynol, act as lipid solvent, killing sperm and all STD agents. Most studies suggest about a 50% reduction in transmission, with perhaps a 33 less transmission of chlamydia. There is one report of possible enhancement of transmission of HIV by use of spermicides, among prostitutes in Africa. Neither condoms nor spermicides protect against extragenital transmission, especially for organisms transmitted by skin contact, i.e., syphilis, herpes, or chancroid. Oral contraceptives provide clear protection, about 50%, against pelvic inflammatory disease (PID), while they may facilitate cervical ectopy, and associated cervical chlamydia and gonorrhea. IUDs, once believed to heighten the risk of PID, now are considered increase this risk only a few days or months after insertion. Such insertion-related infection can be controlled with a single dose of a broad-spectrum antibiotic. Unfortunately those methods which are most effective in preventing pregnancy, pill and IUDs, are not particularly useful in preventing STDs, as are the less effective barriers and spermicides.