Relationship type, negotiated safety, and dual protection in Brazil

Worldwide, women of reproductive age in committed relationships are becoming infected with HIV and experiencing unintended pregnancy. A recent body of research has emerged around dual protection, or the simultaneous protection against HIV and unintended pregnancy. Most dual protection studies measure either condom use or dual method use (condoms plus another method) and many researchers agree that definitions of dual protection must expand to include condom use consistency and other safe sex strategies. This study first assesses condom use consistency and dual method use by relationship type (e.g. married, cohabiting, union, and single). Second, we expand the definition of dual protection to include strategies of negotiated safety, which refers to an agreement between partners on rules regarding their sexual practices within and outside of their relationship.

We use data from the 2006 National Demographic and Health Survey of Women and Children (PNDS), a nationally-representative household survey of Brazilian women of reproductive age (N=15,575). In-depth data were collected on condom use consistency, contraceptive behavior, and partner communication around condom use, contraception, and sexual relations. We use descriptive techniques and logistic regression to examine variation in dual protection behavior (e.g. condom use consistency, long-/short-term methods, and reversible/permanent methods) by relationship type and partner communication.

This presentation will explain and discuss dual protection among sexually active women of reproductive age in Brazil. Findings emphasize the importance of considering relationship type when defining dual protection and highlight negotiated safety as a risk reduction technique for partners in committed relationships.