The effectiveness of barrier methods of contraception in preventing the spread of HIV.

Because barrier methods provide protection against bacterial sexually transmitted diseases, these methods are valuable public health adjuncts irrespective of their effect on HIV. Male latex condoms offer substantial protection against HIV infection. Women at risk of sexual acquisition of HIV infection need one or more prophylactic methods that they can control. While the available spermicide products may serve this purpose, current data do not allow firm casual inferences. Large and well designed epidemiologic studies are required to examine the association between female use of barrier methods and HIV infection. These are difficult and costly to perform, however, and to date have yielded conflicting results. Finally, prospective studies in high-incidence cohorts are necessary, and the relationships between spermicide use, local irritation, the vaginal flora and HIV incidence rates must be clarified.