Barrier contraceptives and spermicides: their role in family planning care.
This WHO manual on barrier contraceptives and spermicides covers all methods, their effectiveness, advantages and disadvantages, non-contraceptive advantages, uses in special cases, family program considerations, the logistics of supply, monitoring shelf-life and quality control, and application of condoms in AIDS prevention programs. Condoms and foaming tablets are the most appropriate methods for developing countries, especially those in the tropics. Other methods present problems such as expense (diaphragms, foams, sponges), unavailability outside the U.K. and U.S. (caps, sponges), bulk and expense (canned foams). Certain individuals are particularly good candidates for barriers and spermicides: lactating women, people using abstinence or natural family planning, adolescents, older women, women waiting to start using other methods, and those at risk for contracting sexually transmitted diseases. Program officials should consider providing supplies in their special environments, with limitations such as transport, reliability of shipments, storage requirements, cultural sensitivity, multiple outlets for supplies, and cost both to the program and to the users. Methods of insuring steady supply and techniques of testing condoms are described. Barrier methods, condoms in particular, help stop the spread of gonorrhea, syphilis, Chlamydia, Candida, Trichomonas and HIV. An appendix describes basic information about AIDS and the relevance of barriers and spermicides, as well as monogamy and abstinence, in preventing AIDS transmission. Other appendices list sources of supply for developing countries, addresses of manufacturers and sources of further information, techniques for using these methods, and teaching methods for illiterates and semi-illiterates.