Two good reasons: women's and men's perspectives on dual contraceptive use

In the US, continued high rates of unintended pregnancy, combined with incr eases in heterosexual transmission of HIV to women, have sharply magnified concern about the factors leading to or barring the use of contraceptive me thods to protect concurrently against both risks. This paper reports on res ults of focus group research among African-American women participating in a longitudinal study and African-American men who are either partners of th e women or are of similar socio-economic status as their partners. We found a high level of agreement between men and women on the issues and problems that both sexes face. People felt that regardless of a woman's use of other contraceptive methods, a condom should always be used for protect ion. This belief, however, differed markedly from actual practice. Although we attempted to discern the relative salience of concern about pregnancy v ersus STIs, we conclude that people may not separate these two concerns in their resolve to use two methods. Furthermore, they recognized the need for dual protection, but expected conflict with their partners from using cond oms as a second method because of high levels of distrust regarding sexual fidelity. Thus people are caught in a bind: distrust further increases the sense of a need for dual methods, but using condoms exacerbates the problem s people have with achieving trust in relationships. (C) 1999 Elsevier Scie nce Ltd. All rights reserved.