Women's Health Research Newsletter • February 2005

Female Controlled Contraception

Happy 2005!

Were you wondering why your New Year’s Party was especially populated this year, or why traffic en route to your New Year’s day gathering was particularly bad?

Perhaps this won’t completely answer that question, but as of the 1st of January of this year, the global population hit 6,409,907,058. The United States population currently stands at 295,163,619.

The just released 2002 National Survey of Family Growth (NSFG), the most recent government survey of sexual health, showed more women using the most effective methods of contraception. Unfortunately, despite continued advances in contraceptive technology, the trends also indicate that a significant percentage of women who are sexually active and not seeking pregnancy are not using contraception; this proportion increased from 5.2% to 7.4% between 1995 and 2002. While the unintended pregnancy rate in the United States has remained stable at 51%, rates of sexually transmitted infection (or STDs are on the rise. Women are particularly susceptible to these infections. It is for this reason that the creation of female controlled contraception that also protects against STDs is an essential public health issue.

Despite the increased prevalence of disease, the NSFG statistics also show that more women than ever reported using a method of contraception at the time of first intercourse (close to 80%). Condoms use represents the bulk of this use, suggesting that education designed to inform women that they can protect themselves from infection through their choice of contraception is working. When this is coupled with the reality that over 38 million people in the world are infected with the HIV virus, and that heterosexual intercourse is the leading cause of HIV in women, it seems to indicate that the vehicle for change may lie in the hands of women.

Condoms are an excellent method for preventing STDs, but this is not always an option for women. One prospective study conducted on HIV negative men in Uganda who were living with HIV positive women provides compelling evidence: Men were individually counseled about the risks of unprotected sex and HIV, and were provided a free, continuous supply of condoms for over two years. At the close of the study, researchers discovered that 89% of the men had never used a single condom during intercourse. The rate of seroconversion among uncircumcised male subjects was 16.7 per 100 person-years, whereas no seroconversions occurred among circumcised male subjects (P< 0.001). (Quinn et al, 2000).

Women have clearly expressed a desire for a vaginal method of contraception that could potentially have some anti-infective function (Darroch and Frost, 1999). The Women’s Health Research Unit at OHSU, together with the Contraceptive Clinical Trials Network, are conducting research to help meet this need. We are conducting a studying examining the efficacy of a promising new non-hormonal method of vaginal contraception using a spermicidal agent called C31G. Preliminary studies have documented that C31G is well tolerated, with sperm-killing properties equivalent to the currently marketed products containing nonoxyl 9. Lab studies suggest that C31G may be less irritating and better at killing bacteria and viruses (including the AIDS virus) than nonoxyl-9, and that this could theoretically prevent the transmission of certain STDs. The current study seeks to enroll women in monomygous relationships into a 6 month trial of the method as a contraceptive. Eligible participants will receive the study spermicide and medical exams at no cost. Women do not need to have insurance to participate in our studies.

For information on this, and other research opportunities, please call the Women’s Health Research Unit’s confidential recruitment line at (503) 494-3666.

Heidi P. Milliken, Ph.D.
Jeffrey Jensen, M.D., M.P.H.