237628 "My mama has boyfriends and is still having babies": Sociocultural aspects of dual protection among young African-American women

Monday, October 31, 2011

Colleen Crittenden Murray, DrPH, MPH , Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA
Winifred Wilkins Thompson, PhD, MSW , Department of Behavioral Sciences and Health Education Rollins School of Public Health, Rollins School of Public Health of Emory University, Atlanta, GA
Kendra Hatfield-Timajchy, PhD, MPH , Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA
Joan Kraft, PhD , Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA
Anna Bergdall, MPH , Division of Reproductive Health, Centers For Disease Control and Prevention Orise Fellow, Atlanta, GA
Sarah Blake, MA, PhD(candidate) , Department of Health Policy and Management, Emory University, Rollins School of Public Health, Atlanta, GA
Laura M. Gaydos, PhD , Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA
Melissa Kottke, MD, MPH , Department of Gynecology and Obstetrics, Jane Fonda Center for Adolescent Reproductive Health, Emory University School of Medicine, Atlanta, GA
Ralph J. DiClemente, PhD , Rollins School of Public Health and Center for AIDS Research, Emory Univeristy, Atlanta, GA
Dual protection (DP) strategies, such as using contraceptives and condoms together, can be effective in preventing unintended pregnancy and disease. The feasibility of DP may be influenced by sociocultural and relationship factors. Ten focus groups were conducted with African-American women (15-24 years) at 3 reproductive health clinics in Atlanta, GA. Participants discussed concerns about preventing pregnancy and disease before discussing DP. Data analysis identified themes related to contraceptive, condom and DP use. Because many participants viewed pregnancy as normative (e.g., everyone is getting pregnant, even our mothers) and STDs as stigmatized (e.g., girls with STDs are “nasty”), most were more concerned about STDs than pregnancy. All groups identified benefits to early childbearing and reported that prevention strategies may not be as relevant until after having children of their own. Despite the desire of some to avoid pregnancy and STDs, participants identified barriers to contraceptive and condom use separately. The greatest barrier to method use concerned relationships, as participants noted having children signals relationship deepening and condom use signals distrust. Although few women heard of DP, they were able to define the term with ease. Participants had favorable responses to the concept of using DP, provided their partners wanted to use dual methods. However, the presumed implications on participants' relationships limit the likelihood of dual method use and acceptance of DP. While DP theoretically holds promise, the acceptability of pregnancy and women's perceptions of barriers to concurrent contraceptive and condom use in serious relationships may pose challenges to promoting DP use.

Learning Areas:
Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Define dual protection. 2. Describe the potential challenges/supports associated with contraceptive, condom and dual protection use among young, African-American women.

Keywords: Disease Prevention, Pregnancy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract Author on the content I am responsible for because I serve as a co-investigator on this project, facilitated all focus groups, and assisted in data analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.