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The Natural Cycles application is a fertility awareness-based contraceptive method that uses dates of menstruation and basal body temperature to inform couples whether protected intercourse is needed to prevent pregnancies.
However, among the 20 subjects who did use condoms there was also a marginally significant trend towards more vaginal E. coli (p = 0.06) and a highly significant increase in other enteric gram-negative rods (p = 0.001) after protected intercourse [ 106].
This may relate to two distinct pathogenetic mechanisms: (1) in case of unprotected intercourse alkalinisation of the vaginal niche enhances a shift from lactobacilli-dominated microflora to a BV-like type of microflora and (2) in case of unprotected and protected intercourse mechanical transfer of perineal enteric bacteria is enhanced by coitus.
However, if this were the only mechanism involved than condom use would be expected to act as a very effective means of prevention - which it is not - and hence the proposed mechanism involving a pH-increase does not quite explain why BV acquisition is almost equally enhanced by protected intercourse, as outlined above.
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The proportion of condom-protected intercourse acts was assessed in men who reported at least one intercourse act.
Secondary outcomes included proportion of condom-protected intercourse acts, unprotected sexual intercourse, multiple sexual partners, insertive anal intercourse, and receptive anal intercourse.
Although BRO did not affect the proportion of condom-protected intercourse acts, unprotected sexual intercourse, multiple partners, or insertive anal intercourse, it did reduce receptive anal intercourse compared with the control, a behavior linked to incident HIV infection.
The HIV/STI risk-reduction and health-promotion interventions did not differ significantly on proportion of condom-protected intercourse acts, unprotected sexual intercourse, multiple partners, or insertive anal intercourse during the follow-up period.
The risk of transmission associated with these specific behaviors is less than it is with receptive UAI with an HIV-positive partner, but remains higher than for condom-protected intercourse [ 4].
The HIV risk-reduction intervention reduced receptive anal intercourse compared with the control group, a behavior tied to elevated risk of incident HIV infection [ 64], but did not increase the proportion of condom-protected intercourse or decrease multiple partners or insertive anal intercourse.
Couples can enroll irrespective of whether they engage in unprotected or protected anal intercourse with each other.
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