Youth at increased risk for STIs need to think about preventing
both pregnancy and STI transmission. In such situations, some
providers are beginning to recommend two methods, or "dual
method" use - one for pregnancy prevention and the second
for STI prevention. Young adults who are at risk for STIs should
be advised to use condoms even if they are using another contraceptive
method.
The male condom is the most effective method for the prevention
of all STIs, including HIV. However, in typical use, condoms
are not as effective at pregnancy prevention as some other methods.
Given this dilemma, young adults need to make an informed choice
about which method or methods to use. Providers should counsel
youth clearly about approaches to dual method use and encourage
youth to take responsibility for making their own choice.
One approach to dual method use is to use a contraceptive method
highly effective at pregnancy prevention, such as the pill or
injectables, and to use a condom for STI prevention. Some research
among young adults shows, however, that the more effective the
contraceptive method used, the less likely youth are to use
condoms for disease prevention.
Another approach for dual protection is to use condoms as the
primary method. Condoms are highly effective at both pregnancy
and disease prevention when used consistently and correctly.
Even with good counseling, however, youth often do not use condoms
consistently. With this approach, youth need be counseled about
using emergency contraception when condoms are not used, or
when they break or slip. Oral contraceptives for emergency contraception
could be provided along with the condoms.
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