Mantell Joanne E, Hoffman Susie, Exner Theresa M, Stein Zena A, Atkins Kim
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, USA.
Perspect Sex Reprod Health. 2003 Mar-Apr;35(2):71-8. doi: 10.1363/3507103.
Family planning providers can play an important role in helping women to identify their risk of HIV and other sexually transmitted diseases (STDs) and to adopt preventive measures. In-depth investigation of providers' attitudes about approaches to STD risk assessment, contraceptive counseling and dual protection--concurrent protection from STDs and unintended pregnancy--has been limited.
In semistructured interviews conducted in 1998, 22 health care providers from a large New York City agency offering contraceptive and STD services described how they balanced STD and pregnancy concerns, viewed risk assessment and assessed various contraceptive methods.
STD prevention was seen as an integral part of family planning counseling, and most providers believed that risk assessment should be conducted universally. Providers viewed dual protection as use of condoms along with an effective contraceptive; few advocated use of the male or female condom alone. The female condom was believed to be a disease prevention method of last resort and was considered appropriate only for specific groups of women. Although providers lacked understanding about the effectiveness of the female condom and how to counsel clients concerning its use, they expressed interest in learning more.
Training is needed to reduce providers' negative perceptions of the female condom and to reinforce the importance of individualized counseling tailored to women's specific circumstances. Studies are needed on how to encourage family planning providers to promote male and female condoms as effective contraceptive methods.
计划生育服务提供者在帮助女性识别感染艾滋病毒和其他性传播疾病（STD）的风险以及采取预防措施方面可以发挥重要作用。对服务提供者关于性传播疾病风险评估方法、避孕咨询以及双重保护（即同时预防性传播疾病和意外怀孕）的态度进行深入调查一直很有限。
在1998年进行的半结构化访谈中，来自纽约市一家提供避孕和性传播疾病服务的大型机构的22名医疗服务提供者描述了他们如何平衡对性传播疾病和怀孕的担忧、看待风险评估以及评估各种避孕方法。
预防性传播疾病被视为计划生育咨询的一个组成部分，大多数服务提供者认为应该普遍进行风险评估。服务提供者将双重保护视为同时使用避孕套和有效的避孕方法；很少有人主张单独使用男用或女用避孕套。女用避孕套被认为是一种最后的疾病预防方法，仅被认为适用于特定的女性群体。尽管服务提供者对女用避孕套的有效性以及如何就其使用向客户提供咨询缺乏了解，但他们表示有兴趣了解更多。
需要进行培训，以减少服务提供者对女用避孕套的负面看法，并强化根据女性具体情况提供个性化咨询的重要性。需要开展研究，以探讨如何鼓励计划生育服务提供者推广男用和女用避孕套作为有效的避孕方法。
