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.
For more information, visit Family Health International's Website at www.fhi.org
Copyright