Predictors of Dual Protection Among Sexually Active Females

Background: Despite recommendations for concurrent use of contraceptives and condoms to prevent unintended pregnancy and STIs, dual protection use among young women is poor. This study examined individual, familial and environmental level factors that predict dual protection use among a sample of sexually active female adolescents receiving psychiatric services. Method: 891 adolescents (13-18 years) receiving psychiatric services in one of three urban areas in the US participating in an HIV prevention trial provided data via ACASI. This study analyzed data from 288 sexually active females who completed baseline assessment prior to randomization in the HIV trial. Sociodemographic, psychosocial, and self-reported behavioral data related to birth control and condom use were collected. Logistic regression was employed to identify predictors of dual protection. Results: 100 (34.7%) participants reported dual protection use in the past three months; 144 (50%) reported using one form of protection, and 44 (15.3) used no protection. Controlling for age and study site, participants who reported multiple partners, higher condom use self-efficacy and living in a cohesive environment were significantly more likely to report dual protection while those with a history of pregnancy were less likely to report dual protection. Conclusions: Findings suggest that intervention messages about dual protection should be specifically targeted toward females with a history of pregnancy and those with multiple partners. Additionally, enhancing self-efficacy for condom use and strengthening the living environment of female adolescents receiving psychiatric services may contribute to adolescents' use of dual protection for STI and pregnancy prevention.