The importance of dual protection for hormonal contraception users at risk for STI/HIV infection.(SEX RESEARCH UPDATE)

Oral contraceptives (OCs) are the most popular method of birth control for Canadian women, including those under the age of 30 (Fisher, Boroditsky, & Morris, 2004). The propensity for young women, and their male partners, to use condoms in the initial stages of a sexual relationship and then abandon condoms once hormonal contraception has been initiated places many of the participants in these relationships at high risk for STI/HIV infection. Few women at high risk for STI/HIV who use hormonal contraception also practice consistent condom use.

Sangi-Haghpeykar, Posner, and Poindexter (2005) examined patterns of condom use discontinuation among first time OC and DMPA (injectable hormonal contraception) users in order to inform effective educational efforts to promote dual protection against pregnancy and STI/HIV among hormonal contraception users. The sample for their study included 426 women attending family planning clinics in Texas who were using OCs or DMPA for the first time and who completed base-line and 3-month follow-up questionnaires. The average age of the participants was 24 with an average of 13 years of education, a fifth were married, and the sample was divided almost equally between blacks, Hispanics, and whites. The participant questionnaires included an extensive range of items on sexual behaviour, sexual communication with partners, number of sexual partners, and condom use. For the study, consistent condom use was defined as using condoms 90% of the time or more in the previous three months.

Most of the women participating in the study believed that they were at no or very low risk for STI. At baseline, 31% of the respondents reported that they were consistent condom users in the three months before beginning oral contraception. At follow-up, 54% of those who were consistent users at baseline had either discontinued or reduced their use of condoms since initiating hormonal contraception. Higher consistency of condom use was associated with younger age and not being married. Over a third of the sample was involved in nonmonogamous relationships and while nearly a third of these women were consistent condom users at baseline, 75% of them did not use condoms after beginning hormonal contraception.

...