Consistent condom use by nonmonogamous sex partners could protect millions of people from HIV infection and other sexually transmitted diseases (STDs) and reduce the enormous costs associated with STDs.  Condom use needs to increase to about 15 billion/year (from 8-10 billion/year) to prevent STDs.  An estimated 33 million people live with HIV/AIDS worldwide, and an estimated 16,000 people are infected with the virus each day.  In 12 out of 15 countries surveyed, more than 75% of never-married men have changed their sex behavior in

Around 60% of married condom users in the world dwell in developed countries, especially in Japan where 45% of married women of reproductive age use condoms.  In developing countries, only 4% of married condom users use them for family planning.  In 1990, couples having sexual relations may have used an estimated 6000 million condoms, but this number falls very short of the >13,000 million condoms needed to protect people from unwanted pregnancy, sexually transmitted diseases and/or AIDS.

 This review on new developments in vaginal contraception examines the history and usage of vaginal methods, assesses the effectiveness, proper use, and safety of spermicides, contraceptive sponges, diaphragms, and cervical caps, discusses the disease prevention effects of vaginal methods, and explores some program issues.  The female vaginal methods are less effective than oral contraceptives, IUDs, or voluntary sterilization, and may entail high risks of accidental pregnancy, especially among women who are not conscientious users.

 An overview of condom use, promotion, and manufacture is presented.  Theoretical effectiveness of condoms is estimated to range from .5-2 pregnancies/100 couple years of use.  Although data are not available on breakage rates during use, estimates of 1/1000 for good quality condoms and 1/100 for poor quality condoms have been offered.  Use-effectiveness rates vary widely; pregnancy rates of .8-22/100 couple years of use have been reported.

 The answer is yes to all 3 of the following questions concerning vaginal chemical spermicides: 1) are they effective; 2) do they make a useful contribution to voluntary family planning programs; and 3) is there any role for vaginal chemical spermicides.  If used properly, spermicides can be more than 95% effective, and they are about 85% effective even if they are not used properly all the time.  They also meet the folowing important needs that other methods may fail to meet: 1) they are safe, with

 Literature on the vaginal diaphragm and other intravaginal barrier devices is reviewed.   Although use of the diaphragm in the U.S.  has declined considerably since the early 1960's, there is some evidence that this trend is being reversed due to disillusionment with oral contraceptives (OC) and the IUD, though this apparent reversal has yet to be established.  Generally, the vaginal diaphragm is ignored as a contraceptive method in developing countr

 Literature on vaginal chemical contraceptive agents is reviewed.  Vaginal contraceptives have been in use for more than 2 centuries, and homemade spermicides are still used among some populations.  There are basically 4 types of vaginal chemical contraceptives: 1) creams, jellies, and pastes which are squeezed from a tube, 2) suppositories which dissolve in the vagina, 3) aerosol or tablet foams, and 4) water-soluble plastic film (C-film) containing a spermicide.  The spermicidal actions of vaginal chemical contraceptives are vario

 The report comprehensively summarizes the use of the condom as a contraceptive and prophylactic.  The nature and history of condoms is discussed and the modern manufacture of latex condoms is described in detail including pricing and material costs.  Industry quality control testing procedures are given and national standards for sampling and test procedures for strength and aging are outlined in detail.  Condom standards by country, testing methods, and

 This report covers in detail the history, usage, and marketing of the condom as a means of contraception.  Worldwide estimates of usage range from 19 to 25 million couples using them as their only birth control method or in combination with other methods.