Condom use among women choosing long-term hormonal contraception
Cushman, L.F.; Romero, D.; Kalmuss, D.; Davidson, A.R.; Heartwell, S.; Rulin, M.
Family Planning Perspectives 30(5): 240-243
1998
ISSN/ISBN: 0014-7354 PMID: 9782048 DOI: 10.2307/2991611Document Number: 278913
Concerns have been raised that women who use long-term hormonal contraceptive methods to prevent pregnancy will fail to protect themselves from sexually transmitted diseases (STDs), including AIDS, through concomitant condom use. This possibility was investigated in a prospective (1993-94), multi-site US (Pittsburgh, Pennsylvania; Dallas, Texas; and New York, New York) study of 1073 new users of either contraceptive implants or Depo-Provera. The mean age of study participants was 23 years; 63% were Hispanic, 24% Black, and 13% White. Overall, the proportion of women who always used condoms in the previous 3 months dropped from 21% at the time of method initiation to 11% at follow-up 6-12 months after enrollment. However, use increased from 25% to 31% among women with more than 1 sexual partner. Significant predictors of dual method use included previous condom use (odds ratio (OR), 2.5); receipt of AIDS-specific counseling (OR, 1.6); the perception, at baseline, of being at some risk of AIDS (OR, 1.4); and more than 1 sexual partner during the study period (OR, 5.4). In addition, injectable users, teenagers, and Black women were more likely than other women to use condoms with their hormonal method. These findings have important implications for family planning programs, especially the need for counseling on the continued importance of condom use for STD prevention when pregnancy is prevented by non-barrier methods.