Dual Use of Condoms and Contraceptives in the USA

While noting the multiple benefits of using condoms along with other methods of contraception -- "prevention of unintended pregnancy, protection against [STI], and sequentially, defense against the threat of infertility" -- the authors wrote that few studies have compared dual method use prevalence or trends, or systemically reviewed dual method use facilitators and barriers across multiple studies. They therefore undertook a review of the literature on dual method use trends and covariates in the United States among both nationally representative and smaller samples.

The results showed that dual method use prevalence estimates vary widely across study populations. However, nationally representative estimates are consistently lower than Western European nations, which in turn report lower rates of unintended pregnancies and STI. Adolescents are the focus of most published work on dual method use. Prior studies have found dual method use associated with several individual-level variables: socio-demographic factors, such as younger age; STI risk behaviors and risk perception; relationship variables, including the number of partners, length of relationship, and partner support for condom use; and educational factors such as prior exposure to messages about HIV prevention.

"Although dual method use appears to be on the rise, especially among adolescents and young adults, US rates are comparatively low and leave much room for improvement," the authors reported. "This review identifies several populations most in need of intervention. However, we encourage public health practitioners to evolve beyond individual-level studies and interventions to focus on the relational, socio-cultural, and structural influences of dual method use. Dual use promotion programs and policies should also equally target men and women, adolescents and adults."

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