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

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.