Barriers against STDs: what about planned pregnancy? [letter]

We welcome Anne Philpott and colleagues proposal that barriers against sexually transmitted diseases should be designed to promote sexual pleasure. We agree that the uptake and consistency of use of such barriers and hence their effectiveness would be thereby enhanced. This is surely a concern to be kept in mind by those who design physical and chemical barriers. Also those who aim to dispense them to potential users have to work within the cultural constraints of the society to maximise their pleasurable use. An issue no less fundamental and in need of attention however is that for many young women and men conception is also an integral part of sexual relationships. Fertility is not only desirable but essential to the maintenance of the community. There are many individuals who will accept neither physical barriers such as condoms nor microbicides that are contraceptive even if the risk of infection is reported to be high. (excerpt)