Ks. Riehman et al., DUAL-METHOD USE AMONG AN ETHNICALLY DIVERSE GROUP OF WOMEN AT RISK OFHIV-INFECTION, Family planning perspectives, 30(5), 1998, pp. 212-217
Context: Few U.S. women protect themselves against both pregnancy and
sexually transmitted diseases (STDs) by using an efficient contracepti
ve method and a condom. Understanding the factors that influence dual-
method use could help improve interventions aimed at encouraging prote
ctive behaviors. Methods: Interviews were conducted with 552 low-incom
e women at risk of HIV who attended public health or economic assistan
ce facilities in Miami in 1994 and 1995. Multinomial legit analyses we
re used to determine the influence of women's background characteristi
cs, perceived vulnerability to pregnancy and AIDS, and relationship ch
aracteristics on the odds of dual-method use. Results: Overall, 20% of
the women used dual methods. Women who were not married, who worried
about both pregnancy and AIDS, who had ever had an STD, who were confi
dent they could refuse a sexual encounter in the absence of a condom a
nd who made family planning decisions jointly with their partner were
the most likely to use dual methods rather than a single method (odds
ratios, 2.0-3.5); those who considered the condom only somewhat effect
ive in preventing AIDS or who shared economic decision-making with the
ir partner were the least likely to use dual methods rather than a sin
gle method (0.5-0.6). The results were generally similar in analyses e
xamining the odds of dual-method use involving an efficient contracept
ive, except that black and Hispanic women were significantly more like
ly than whites to use condoms in conjunction with efficient contracept
ives (3.3-7.1). Conclusions: Both women's individual characteristics a
nd the context of their sexual relationships influence whether they si
multaneously protect themselves from pregnancy and HIV. The involvemen
t of male partners in family planning decision-making and women's cont
rol over economic decision-making ensure greater protection against HI
V infection.