Comparative Contraceptive Efficacy of The Female Condom and Other Barrier Methods

Abstract

Because the research design for the clinical trial establishing the contraceptive efficacy of the female condom--a six-month life-table probability of failure of 15% (12% in the United States vs. 22% in Latin America)--did not include randomization with another method of contraception, no definite conclusion about its comparative efficacy is possible. Comparisons using other female barrier methods as historical controls, however, provide evidence that, among women in the United States, the contraceptive efficacy of the female condom during typical use is not significantly different from that of the diaphragm, the sponge or the cervical cap. The six-month probability of failure during perfect use of the female condom is 2.6% among U.S. women, similar to rates for the diaphragm and the cervical cap but significantly lower than that for the sponge. Meaningful comparisons with the male condom are not possible because of the lack of data from carefully controlled prospective clinical trials. Extrapolations from the results on contraceptive efficacy suggest that perfect use of the female condom may reduce the annual risk of acquiring the human immunodeficiency virus by more than 90% among women who have intercourse twice weekly with an infected male.

Influence of Partner Type on Condom Use

“…Though condoms reduce the risk of HIV transmission during vaginal intercourse by approximately 90% (Trussel et al, 1994), condom use among inner-city African American women remains relatively low (Jemmott & Jemmott, 1991;Kelly et al, 1994). Efforts to increase condom use among African American women may be more effective when the social, economic, and cultural realities of their lives are addressed, in addition to the gender specific issues.…”

Female-Initiated Barrier Methods for the Prevention of STI/HIV: Where Are We Now? Where Should We Go?

“…A Medline key word search of "female condom" at press time resulted in a listing of 123 articles on various aspects of safety, acceptability, and efficacy. While the first two have been well established 38,39 and rigorous studies on the contraceptive efficacy of the female condom have been done, [40][41][42] data on the efficacy against STI are limited, 43,44 and more studies, especially those involving long-term follow up, are needed.…”

Contraceptive efficacy and acceptability of the female condom.

“…However, the overall use-effectiveness that we observed in the US subgroup is within the range of rates reported for US women using the cervical cap, the contraceptive sponge, and the diaphragm with spermicide.7 Several factors probably bias the pregnancy rates for the female condom upward compared with these historical rates, in particular the fact that in this study, all pregnancies, including chemical pregnancies (those diagnosed only by urine pregnancy tests) that led to spontaneous abortion, were counted in the failure rates and couples with low coital frequency were excluded from the analysis. 7 In theory, female condoms offer many potential advantages over male condoms.13 The female condom can be inserted in advance of sexual activity and, as a result, should allow more sexual spontaneity. Couples could engage in sexual intercourse before full erection of the penis.…”