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Barrier contraceptives use a physical shield to prevent the male sperm meeting the female egg: this group comprises standard condoms that fit onto the penis, female condoms that fit into the vagina, and diaphragms and cervical caps which are inserted through the vagina and fitted over the opening of the cervix.

Standard condoms are widely available through supermarkets, chemists, vending machines and sexual health services, and they are often given out for free at gay community events. They are estimated to have a 5-10% failure rate for pregnancy, according to the Australian FPA Health website: www.fpnsw.org.au/sex-matters/factsheets/23.html, but are very effective if used properly with water-based lubricant.

Diaphragms and caps

Diaphragms and caps need to be expertly fi tted by a doctor initially, and from then on are self-inserted. Both diaphragms and caps are rubber devices that fit over the cervix, and there are two different versions of each.

For detailed information about how these devices are different and how they are inserted, see www.fpnsw.org.au/sex-matters/factsheets/53.html

The effectiveness(Of a drug or treatment). The maximum ability of a drug or treatment to produce a result regardless of dosage. A drug passes efficacy trials if it is effective at the dose tested and against the illness for which it is prescribed. In the standard procedure, Phase II clinical trials gauge efficacy, and Phase III trials confirm it. of diaphragms and caps as contraceptives is hard to measure, as it depends on many factors such as remembering to use the device, and positioning it correctly. Australian sexual health services estimate that if 100 women used diaphragms and caps for a year, between four and twenty of them would get pregnant.

There is no added contraceptive benefi t in using spermicide with diaphragms or caps.

Female condoms

‘Female’ condoms (Femidom) might be a good option for women with HIV, but they are not readily available in Australia as they are not popular and have a use-by date. They can be ordered over the Internet, however, and are available at some sexual health clinics. Female condoms are slightly less effective at preventing pregnancy than male condoms: 95 % effective compared with 98%. This is comparable to the efficacy of the diaphragm or cap.

The main disadvantage to barrier contraception is that to be effective it needs to be used, and used correctly, each time sexual intercourse occurs.

Many find this onerous. In instances where barrier contraception fails, or when it is not used, emergency hormonal contraception (the ‘morning after’ pill) or an IUD can be used as a back up. (Although the old-fashioned IUD may not be such a good option for women with HIV because of the menstrual and other pelvic problems it can cause.)

For more information see www.fpnsw.org.au/sex-matters/factsheets/52.html

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