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Dual contraceptive method use for pregnancy and disease prevention among HIV-infected and HIV-uninfected women: the importance of an event-level focus for promoting safer sexual behaviors.

Sexually Transmitted Diseases 2003;30(11):809-812.

Wilson TE, Koenig LJ, Walter E, Fernandez I, Ethier K.

Abstract
BACKGROUND AND OBJECTIVES: Many women who report condom use also use other methods of birth control such as oral contraceptive pills. The use of 2 or more contraceptive methods often results in less consistent condom use. GOAL: This study sought to document the prevalence and patterns of such dual contraceptive use among HIV-seropositive and HIV-seronegative women, and to assess factors associated with condom-only versus dual contraceptive use. STUDY DESIGN: At 6 months postpartum, 361 sexually active women were interviewed regarding sexual behavior, male condom and other contraceptive use, and psychosocial factors. RESULTS: Dual contraceptive method use was reported by 39% of sexually active women; 30% reported using condoms only. Almost two thirds of dual method users (64%) reported always using these methods together (ie, simultaneously) during vaginal sex. Among dual users, those who used methods simultaneously were more likely to be HIV-seropositive (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.2-6.5), to believe that a pregnancy would be very upsetting should it occur in the next 6 months (OR, 2.4; 95% CI, 1.1-5.4), and to report no alcohol use (OR, 3.7; 95% CI, 1.5-9.2). CONCLUSION: Dual contraceptive users should be encouraged to use methods together at every episode of vaginal sex. Interventions promoting simultaneous use should include pregnancy attitudes and the role of alcohol use, as well as a consideration of HIV serostatus as it impacts on dual use.