title: Helping patients handle accusations of infidelity.
abstract: You may have experience with women patients who assume their partners are being unfaithful if they try to use condoms because that behavior could indicate they are trying to prevent potential sexually transmitted diseases (STDs).  These same women may believe the same will be assumed of them if they begin to use the new female condom.  If women present the device to their partners in the context of a birth control product rather than a device to prevent STDs, men might be more willing to accept it, says sexuality expert Beverly Wipple, PhD, RN, an associate professor at Rutgers State University of New Jersey in Newark and the author of Safe Encounters:  How a Woman Can Say Yes to Pleasure and No to Unsafe Sex (Pocketbooks, 1990).  Wipple has been a leader in female sexuality research since 1979, having conducted the original research on the "G-spot" (Dell Publishers, 1983).  Wipple bases her hypothesis on a presentation about the male condom given at the 1992 annual meeting of the International Society for the Scientific Study of Sex, held in San Diego.  The presenter showed that if women were using the male condom as their only form of contraception, then the male was more likely to use it.  If the woman was taking oral contraceptives or using another form of contraception--and was only relying on the condom or STD protection--then the male was less likely to use the condom.   "I think the same thing might apply to the female condom," Wipple suggests.  "If she identifies that this is her method of birth control.  I think it is much more likely to be accepted than if she says she is using it to prevent the spread of diseases."  Wipple says practitioners should tell women to emphasize the birth control angle and downplay the STD angle.  "It may not be the only method they are using, but they don't have to tell him that." she says.  "This way, it is not putting an accusation [of infidelity] on him."  While she acknowledge and dislikes the lack of honesty inherent in this practice, she says the end justifies the means. "Although it is not addressing the issues that should be addressed, we have to recognize there are people in situations where it is just impossible for them to address the issues," Wipple explains.  She says this inability to communicate has led to the spread of STDs.
mesh_terms: D001290:Attitude; D001519:Behavior; D003267:Contraception; D003268:Contraception Behavior; D003274:Contraceptive Devices, Female; D004194:Disease; D005193:Family Planning Services; D015438:Health Behavior; D007239:Infections; D009042:Motivation; D011584:Psychology; D012749:Sexually Transmitted Diseases
keywords: Attitude; Barrier Methods; Behavior; Contraception; Contraceptive Methods; Contraceptive Usage--women; Diseases; Family Planning; Infections; Motivation; Psychological Factors; Reproductive Tract Infections; Risk Reduction Behavior; Sexually Transmitted Diseases--prevention and control; Vaginal Barrier Methods; Vaginal Shield