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  1. 1

    Helping women understand contraceptive effectiveness.

    Shears KH; Aradhya KW

    Mera. 2008 Sep; iii-vi.

    When a woman chooses a contraceptive method, effectiveness is often the most important characteristic she considers. Knowing the risks and benefits of each method, including its effectiveness, is necessary for a woman to make a truly informed decision. Yet, many women do not understand how well various methods protect against pregnancy. Health professionals usually explain effectiveness by informing women of the expected pregnancy rates for each method during perfect use (when the method is used consistently and correctly) and during more typical use (such as when a woman forgets to take all of her pills). However, the World Health Organization (WHO) has recently endorsed a simple evidence-based chart that healthcare providers can use to help women understand the relative effectiveness of different methods -- a concept that is much easier for most people to grasp. Key points of this article are: 1) Clinicians play an important role in ensuring that women understand the concept of effectiveness -- a key element of informed choice; 2) Women are able to understand the relative effectiveness of contraceptive methods more easily than the absolute effectiveness of a particular method; and 3) A new chart that places the methods on a continuum from least to most effective can help health professionals better communicate about contraceptive effectiveness.
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  2. 2
    Peer Reviewed

    Interaction of condom design and user techniques and condom acceptability.

    Gerofi J; Deniaud F; Friel P

    CONTRACEPTION. 1995 Oct; 52(4):223-8.

    In November 1991 in Cotonou, Benin, 30 sex workers complained that the World Health Organization (WHO) blue condoms were not as good as the USAID condoms. The National AIDS Programme had replaced the USAID condoms with WHO condoms. Leading complaints about WHO condoms were in order of importance: causes pain in vagina, too short, too small, insufficient lubrication, breaks easily, and several condoms needed per client due to breakage. Samples of both condoms underwent laboratory tests to learn more about the complaints. Informal interviews were conducted with professionals in contact with users (e.g., family planning workers and condom vendors) and condom users (prostitutes, bar girls, and men). There were some differences between the two condom types. For example, the USAID condom exerted 20-30% less pressure on the penis than the WHO condom. However, researchers considered the differences to be too small to completely explain the complaints. Two social workers had done a suboptimal job of explaining to sex workers how to unroll condoms. Other than these sex workers, others accepted the WHO condom well. Both condoms had at least the same strength, suggesting that other factors likely explain the complaints (e.g., breakage). The WHO condom had less lubricant than the USAID condom (223 vs. 451 mg), yet the amount was within the range of that on the commercial market. One batch of WHO condoms had much less lubricant than other WHO batches. Even though the sex workers complained that the WHO condom was too short, it was actually longer than the USAID condom, suggesting that the WHO condoms were not unrolled completely. These findings indicate the need to teach correct application procedures to condom users and to make condoms as immune as possible to incorrect or suboptimal techniques (e.g., changes in lubricant).
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