Dual-method use among an ethnically diverse group of women at risk of HIV infection
Riehman, K.S.; Sly, D.F.; Soler, H.; Eberstein, I.W.; Quadagno, D.; Harrison, D.F.
Family Planning Perspectives 30(5): 212-217
1998
ISSN/ISBN: 0014-7354 PMID: 9782043 DOI: 10.2307/2991606Document Number: 278912
Promotion of condom use among women who use efficient contraception is essential to protect them from sexually transmitted diseases (STDs), including HIV, as well as pregnancy. However, fear of negative reactions from a male partner may prohibit dual method use among women who are economically dependent on men. To understand the factors that influence dual method use, interviews were conducted with 522 low-income US women at risk of HIV who attended 21 public health, family planning (FP), and STD clinics or economic assistance centers in Miami, Florida (US), in 1994-95. 54% were concerned about both pregnancy and AIDS; 32% were worried about AIDS only and 5% about pregnancy only. 20% of respondents reported dual method use; overall, 36% of women used condoms (either alone or along with another method). The rate of dual method use was 16% among Whites, 24% among Blacks, and 21% among Hispanics. The likelihood of dual method use was significantly enhanced (odds ratio, 2.0-3.5) among women who were not married, worried about both pregnancy and AIDS, had ever had an STD, were confident they could refuse sex with a man who would not use a condom, and made FP decisions jointly with their partner. Women who regarded condoms as only somewhat effective in preventing HIV infection or who shared economic decision-making with their partner rather than making such decisions alone were least likely to use dual methods. Black and Hispanic women were significantly more likely than White women to use condoms in conjunction with efficient contraception.