Recommendation: Barrier methods should be part of the
method mix in all family planning/reproductive health
clinics. The advantages of barrier methods, such as
STD protection, should be emphasized to providers and
clients, as should be the importance of correct and
consistent use to achieve pregnancy protection. Barrier
methods provide less protection against pregnancy and
STDs with typical use.
Barrier methods should be presented to clients equally
with other methods, allowing the client to choose the
method most suitable for him or her.
Rationale: Many users of family planning are at risk of
contracting sexually transmitted diseases (STDs)
including HIV, and yet they are unable to avoid their
risky sexual encounters. Therefore they need preventive
methods. Barrier methods are the only class of family
planning methods that protects users against STDs. A
second reason that barrier methods are important is
that some people in need of family planning are not
medically eligible to use, or are unwilling to use,
hormonal methods, IUDs, NFP, or surgical contraception.
Yet anecdotal evidence points to provider bias against
barrier methods. Providers may perceive barriers to be
ineffective; they may also worry about the time
required for client education, motivation, and fitting
(in the case of the diaphragm and cervical cap).
While the typical effectiveness of barrier methods is
indeed less than that of hormonals and IUDs, for consistent and correct users, barrier method effectiveness
is quite high. Although some barrier methods do require
more time with new acceptors, the potential benefits
of STD prevention and communication with sexual
partners are considerable (8, 79, 202, 279).
