Contraception and safer sex
Potts, M.; Smith, J.B.
Bailliere's Clinical Obstetrics and Gynaecology 6(1): 199-211
1992
ISSN/ISBN: 0950-3552 PMID: 1633658 DOI: 10.1016/s0950-3552(05)80126-9Document Number: 323176
Much remains to be learned about the microbiological dynamics of male to female heterosexual HIV transmission. Research has yet to determine whether infections results from female exposure to free virus in semen, HIV-infected white cells, or both. Once in the woman's reproductive tract, does HIV penetrate cervical mucus or vaginal epithelium, transverse a cervical ectopy, or enter the bloodstream at some alternative site. Empirical evidence does support the existence of differing degrees of individual HIV infectiousness and susceptibility. Male to female transmission is thought to be more efficient than vice versa, and infection with another STD is an important independent factor contributing to susceptibility to HIV. Given the difficulty of obtaining clinical data on these questions, it is difficult to advise people on their contraceptive options. This quandary rings especially true when one considers that some contraceptives may reduce the risk of HIV infection, while others may help facilitate its entry. With these concerns in mind, the authors discuss available information on chemical and mechanical barrier methods, natural methods such as breast feeding, ovulation prediction, and coitus interruptus, as well as methods under development. Prevention strategies are discussed in a closing section.