Protecting Against Both Pregnancy and Disease: Predictors of Dual Method Use Among a Sample of Women

Abstract

Although male condoms are the best form of protection against HIV/STDs, they are not the most effective method for preventing unintended pregnancy. Consequently, use of condoms and a highly effective contraceptive-referred to as dual use-is recommended as the optimal protection against both disease and pregnancy. However, little is known about the factors that promote dual use. This study examined associations of dual method use with women's background characteristics, intrapersonal factors, and relationship characteristics. Data are from a random sample of women selected from a large managed care organization in the Pacific Northwest. The analytic sample contained 371 women who completed a telephone survey and reported use of contraceptives in the past 3 months. Three mutually exclusive method use groups were constructed: effective contraceptive only (hormonal methods, intrauterine device, surgical sterilization) (59%), condom only (24%), and dual use (18%). Variables hypothesized to influence dual use were compared across the three groups in bivariate and multivariate analyses. Findings indicate that women who were younger, reported more than one sexual partner in the past year, and were highly motivated to avoid HIV/STDs--were more likely to use dual methods rather than condoms only or an effective contraceptive method. Women confident about using condoms without feeling embarrassed or breaking the sexual mood were more likely to use dual methods rather than a single effective method. Finally, women with confidence in their ability to use condoms correctly are more likely to rely solely on condoms. Policy and practice implications are discussed.

Reproductive Choice for Women and Men Living with HIV: Contraception, Abortion and Fertility

“…General health behaviour or personality-related factors play a comparatively minor role. 55 In addition, dual method use has been correlated with having received HIV education or condom use instructions, 56 an elevated STI risk, 57,58 being in shortterm or less committed relationships and making shared decisions about contraceptives. 53 Many hopes have been placed on female-controlled methods in the context of dual protection, such as the female condom.…”

Dual Protection: More Needed than Practised or Understood

“…16 An entrenched bias against condoms on their own is common in the family planning literature, often expressed as follows: ''no single contraceptive, including the male condom, provides complete protection against both'' 17 or ''although male condoms are the best form of protection against HIV/STDs, they are not the most effective method for preventing unintended pregnancy'' . 18 Ironically, HIV prevention messages often say just the opposite.…”

Adolescent Dual Method Use: Relevant Attitudes, Normative Beliefs and Self-Efficacy

“…Research suggests that relevant attitudes may include youths' condom use beliefs [16,17], perceived risks of pregnancy and STD [11,18,19] In-home surveys included questions about sexual and contraceptive behaviors, attitudes and beliefs about sex and contraception, as well as other health behaviors and personal characteristics. Only participants 15 years of age and older were asked to respond to questions related to sexual attitudes.…”

“…Research suggests that relevant attitudes may include youths' condom use beliefs [16,17], perceived risks of pregnancy and STD [11,18,19] and level of motivation to avoid pregnancy and STD [19,20]. Relevant social normative influences may include parent communication about sexual risk [20,21] and perceived partner support for condom use [16,22].…”

“…Relevant social normative influences may include parent communication about sexual risk [20,21] and perceived partner support for condom use [16,22]. Condom negotiation selfefficacy and skills to refuse sex without condoms have also been identified as important correlates of dual method use [17,19].…”