Strategy |
Protection against HIV |
Protection against pregnancy |
Estimated use in Brazil (general population) |
Oral sex without protection |
Risk reduced by 35 times compared to anal sex Receptive oral sex = 0.04% among MSM66 . Baggaley RF, White RG, Boily MC. HIV transmission risk through anal intercourse: systematic review, metaanalysis and implications for HIV prevention. Int J Epidemiol 2010; 39(4): 1048-63.
|
100% |
Oral sex with last partner (without reference to protection): M=45% and W=41%8
|
Anal sex without protection |
Risk increased by 18 to 20 times when compared to vaginal sex66 . Baggaley RF, White RG, Boily MC. HIV transmission risk through anal intercourse: systematic review, metaanalysis and implications for HIV prevention. Int J Epidemiol 2010; 39(4): 1048-63.
77 . Boily MC, Baggaley R, Wang L, Masse R, White R, Hayes R, Alary, M. Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies. Lancet Infect Dis 2009; 9(2): 118-29.
2020 . Grulich AE, Zablotska I. Commentary: probability of HIV transmission through anal intercourse. Int J Epidemiol 2010; 39(4): 1064-5.Transmission probability: 1.69% per receptive anal contact7
|
Close to 100% |
Anal sex with last partner (without reference to protection): M=23% and W=16%88 . Barbosa RM, Koyama MA; Grupo de Estudos em População, Sexualidade e AIDS. Sexual behavior and practices among men and women, Brazil 1998 and 2005. Rev Saúde Pública 2008; 2(Supl. 1): 21-33.
|
Coitus interruptus in vaginal sex |
Probable risk reduction, lacking conclusive studies2121 . Jones RK, Fennell J, Higgins JA, Blanchard K. Better than nothing or savvy risk-reduction practice? The importance of withdrawal. Contraception 2009; 79(6): 407-10.
2323 . Richters J. Coitus interruptus: could it reduce the risk of HIV transmission? Reprod Health Matters 1994;2(3):105-7.
|
Effectiveness Failure: ranges from 14 to 24%2424 . Kost K, Singh S, Vaughan B, Trussell J, Bankole A. Estimates of contraceptive failure from the 2002 National Survey of Family Growth. Contraception 2008; 77(1): 10-21.
|
Current use25Single women: 1.0% Women in couples: 2.1% |
Coitus interruptus in anal sex |
Probable risk reduction, lacking conclusive studies2121 . Jones RK, Fennell J, Higgins JA, Blanchard K. Better than nothing or savvy risk-reduction practice? The importance of withdrawal. Contraception 2009; 79(6): 407-10.
2323 . Richters J. Coitus interruptus: could it reduce the risk of HIV transmission? Reprod Health Matters 1994;2(3):105-7.. Transmission probability: 0.65% per receptive anal contact among MSM2626 . Jin F, Jansson J, Law M, Prestage GP, Zablotska I, Imrie JC, et al. Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART. AIDS 2010; 24(6): 907-13.
|
100% |
No data were found in this regard |
Diaphragm and cervical cap |
Probable risk reduction, no studies to date2727 . Gollub E, Stein Z. Living with uncertainty: acting in the best interests of women. AIDS Res Treat 2012; 2012: 524936.
|
Effectiveness of diaphragm use Failure: 2.6% to 20%2828 . Brasil. Ministério da Saúde. Secretaria de Políticas de Saúde. Área Técnica de Saúde da Mulher. Assistência em Planejamento Familiar: Manual Técnico. 4.ed. Brasília/DF; 2002.
|
Current use25Single women: 0.0% Women in couples: 0.0% |
Hormonal contraception: oral and injectable |
Probable risk increase for women using injectable progestogens2929 . Heffron R, Donnell D, Rees H, Celum C, Mugo N, Were E, et al. Use of hormonal contraceptives and risk of HIV-1 transmission: a prospective cohort study. Lancet Infect Dis 2012; 12(1): 19-26.
3030 . Morrison CS, Skoler-Karpoff S, Kwok C, Chen PL, Van de Wijgert J, Gehret-Plagianos M, et al. Hormonal contraception and the risk of HIV acquisition among women in South Africa. AIDS 2012; 26(4): 497-504.
|
Effectiveness Failure: 7 to 9% respectively2424 . Kost K, Singh S, Vaughan B, Trussell J, Bankole A. Estimates of contraceptive failure from the 2002 National Survey of Family Growth. Contraception 2008; 77(1): 10-21.
|
Current use of oral contraceptives25Single women: 24.7% Women in couples: 30.3% Current use of injectable contraceptives Single women: 4.5% Women in couples: 4.0% |
Circumcision |
Risk reduction by 60% among men Inconclusive clinical studies for women (protection against HPV cervical cancer); ecological studies show protection3131 . Weiss HA, Hankins CA, Dickson K. Male circumcision and risk of HIV infection in women: a systematic review and meta-analysis. Lancet Infect Dis 2009; 9(11): 669-77.(probability of transmission = 0.11% per receptive anal contact among MSM, when partner is circumcised2626 . Jin F, Jansson J, Law M, Prestage GP, Zablotska I, Imrie JC, et al. Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART. AIDS 2010; 24(6): 907-13.) |
No protection |
Not adopted in Brazil as a public policya. |
Use of preservatives (M/F) |
Risk reduction by 80%b1.14 infections per 100 people/year with consistent use in penetrative vaginal sex3232 . Weller S, Davis K. Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev 2002; (1): CD003255.Data not found for anal sex in heterosexual relationships |
Effectiveness Failure: 15% to 21%2424 . Kost K, Singh S, Vaughan B, Trussell J, Bankole A. Estimates of contraceptive failure from the 2002 National Survey of Family Growth. Contraception 2008; 77(1): 10-21.
|
Current use (no reference to consistency)25Single women: 26.0% Women in couples: 12% Use in the last vaginal intercourse: M=32% and W=24%8Use in the last anal intercourse: M=40% and W=50% |
Tubal ligation and vasectomy |
No protection, but condom use is lower among sterilized women or those with vasectomized partners, among WLHA and WNLHA1111 . Kiyomi T, Barbosa RM, Gipson G. Dual protection dilemma. In: Anais Populations Association of America 2013 Annual Meeting; New Orleans. Disponível em http://paa2013.princeton.edu/papers/132424. http://paa2013.princeton.edu/papers/1324...
2323 . Richters J. Coitus interruptus: could it reduce the risk of HIV transmission? Reprod Health Matters 1994;2(3):105-7.
|
Effectiveness Failure: 0.05%2828 . Brasil. Ministério da Saúde. Secretaria de Políticas de Saúde. Área Técnica de Saúde da Mulher. Assistência em Planejamento Familiar: Manual Técnico. 4.ed. Brasília/DF; 2002.
|
Tubal ligation25Single women: 10.9% Women in couples: 29.1% Vasectomy Single women: 0.1% Women in couples: 5.1% |
Emergency contraception |
No protection, but its use can prevent pregnancy in case of not using condoms or other contraception methods |
Effectiveness = 75 and 80%3434 . Brasil. Ministério da Saúde. Secretaria de Atenção a Saúde. Departamento de Ações Programáticas Estratégicas. Anticoncepção de emergência: perguntas e respostas para profissionais de saúde. 2.ed. Brasília/DF; 2011.Failure: 2% |
Use during lifetime25Single women: 23.2% Women in couples: 11.0% |
Mutual faithfulness and testing without preservative |
Theoretically, 100% protection, but this negotiation is particularly problematic in heterosexual relationships |
No protection |
During lifetime9M=27.2% and W=45.6% In the last year M=11.2% and W=16.2% |