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Barrier contraceptives

Barrier methods provide contraception by preventing the sperm from entering the uterus and are among the old techniques of pregnancy prevention. They are an ideal option for women who cannot or do not want to use hormonal contraception. There are many types of barrier methods, among which male and female condoms are the most commonly used ones. Male or female condoms are the only contraceptive methods that protect against sexually transmitted infections (STI) including human immunodeficiency virus (HIV).

Male condoms were primarily made of latex. However, due to allergies and sensitivities to latex, non-latex (polyurethane or synthetic elastomers) male condoms were introduced in 1990s[1]. Today one can find all varieties of male condoms differing in colour, flavour, size and additional design features. There are numerous producers of male condoms world over. Among them, over 25 of them have attained WHO/UNFPA prequalification and over 11 have USFDA approval. Male condoms are among the top three widely procured commodities procured globally using Global Fund (GF) grants for prevention of HIV/AIDS[2]. Comparison of procurement costs between country direct procurement and through donor system did not show great variation and remained relatively stable over the past decade, thus indicating a stable market for male condoms.

On the other hand, in comparison to male condom, female condom is a relatively new product launched in late 1930s. Female condom is generally made of natural rubber latex or synthetic latex (nitrile). The range of female condom designs are increasing on the market, some of them at various stages of development. Currently two of them are WHO/UNFPA prequalified and one is approved by USFDA. Here the economic theory that prices fall as competition increases is duly applied. But looking at the international drug price indicator guide, there has been a relatively modest decrease in female condom price. Therefore it is not surprising that globally efforts are being made to encourage new female condom manufacturers to increase variety and competition.

[1] Gallo MF; Frimes DA; Lopez MA; Schulz KF. Non-latex versus latex male condoms for contraception. Cochrane Database of Systemic Reviews, 103, 1 (2006).

[2] Wafula F, Agweyu A, Macintyre K. Trends in procurement costs for HIV commodities; a 7-year retrospective analysis of global fund data across 125 countries. Journal of Acquired Immune Deficiency Syndromes 65, 4 (2014): 134-139, 10.1097/QAI.0000000000000053


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