Consistent use of barrier methods may decline when clients employ the "dual-method" approach, using a barrier method for protection against sexually transmitted diseases (STDs) but another method for contraception.
In an analysis of dual-use studies, Dr. Willard Cates of FHI found that "the more effective the primary contraceptive method was in preventing pregnancy, the lower the level of consistent use of the male condom."1 For example, a U.S. study in Baltimore, MD found that among 92 adolescent women who were using oral contraceptives and were at high risk for STDs, only 10 percent used condoms consistently.2
But factors other than the method itself appear to affect levels of concurrent condom use, says Dr. Cates, FHI's corporate director of medical affairs. In a multisite study where spermicides were the primary contraceptive method, wide variations were found in the degree of consistent condom use, from 75 percent in Mexico to only 4 percent in the Dominican Republic.3
FHI is conducting a study of dual method acceptability, where women using oral contraceptives are given the choice of spermicide film or male condoms for disease protection. "Preliminary data indicate that giving the women a choice for disease prevention increases the degree of consistent use," says Markus Steiner of FHI, study coordinator.
-- William R. Finger
Footnotes
- Cates W. Contraceptive choice, sexually transmitted diseases, HIV infection and future fecundity. J Br Fertil Soc 1996; 1(1):18-22.
- Weisman CS, Plichta S, Nathanson CA, et al. Consistency of condom use for disease prevention among adolescent users of oral contraceptives. Fam Plann Perspect 1991; 23(2):71-74.
- Steiner M, Joanis C. Acceptablity of dual method use. Fam Plann Perspect 1993; 25(5):234.
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