Online Program

Dual method use at last sexual encounter: An episode-level analysis from a nationally representative survey of US men and women

Tuesday, November 5, 2013 : 5:00 p.m. - 5:15 p.m.

Jenny Higgins, PhD, MPH, Gender and Women's Studies, University of Wisconsin-Madison, Madison, WI
Nicole Smith, MPH, CHES, CPH, Office of Population Research, Princeton University, West Windsor, NJ
Stephanie Sanders, PhD, The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN
Vanessa Schick, PhD, Center for Sexual Health Promotion, Indiana University, Bloomington, IN
Debby Herbenick, PhD, MPH, Center for Sexual Health Promotion, Indiana University-Bloomington, Bloomington, IN
Brian Dodge, PhD, Center for Sexual Health Promotion, Indiana University-Bloomington, Bloomington, IN
Michael Reece, PhD, MPH, School of Public Health, Indiana University-Bloomington, Bloomington, IN
J. Dennis Fortenberry, MD, MS, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
Context & Background: Using condoms in conjunction with other contraceptives can increase protection against pregnancy and STIs. However, few analyses have 1) examined dual method use at the level of the sexual episode or 2) included men or explored gendered patterns in reporting. Methods: We analyzed dual use patterns using a nationally representative dataset of 18-44 year-olds in the US (N=662 men, 600 women). Respondents indicated which, if any, contraceptive methods they used at last vaginal intercourse. Results: Preliminary findings reveal that eight (7.8%) percent of respondents used a male condom plus a hormonal method at last vaginal intercourse, a figure that did not differ significantly by gender. However, only 60% of dual users reported condom use during the entire intercourse episode; 34% initiated intercourse without a condom, and 6% removed the condom during intercourse. Men were significantly more likely to report these condom errors. Moreover, not all respondents who used dual methods at last sexual episode had done so consistently: only 22% of dual users reported condom use in 10 out of the last 10 intercourse episodes, compared to 78% of condom-only users. Discussion: Many people classified as "dual users" in previous studies may not be using dual methods appropriately or regularly. Researchers and practitioners should inquire how and how often condoms are used when assessing and addressing dual method use. Furthermore, though men have rarely been surveyed about dual use, they may provide more accurate reports of condom practices such as late application or early removal.

Learning Areas:

Public health or related research

Learning Objectives:
List the benefits of dual contraceptive method use. Demonstrate familiarity with national prevalence rates, patterns, and trends of dual method use in the US, as well as the limitations of prior research in this area. Compare the proportion of men and women reporting use of a male condom and hormonal contraceptive method at last vaginal intercourse, based on a nationally representative sample of 15-44 year-olds in the US. Assess the large minority of these dual method users who used condoms inappropriately and/or inconsistently. List some of the socio-demographic and sexual variables most strongly associated with dual method use at last sexual encounter. Formulate an agenda for future research and programs regarding dual method use, particularly pertaining to correct and consistent use of condoms.

Keyword(s): Condom Use, Contraception

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted 10 years' worth of research on sexual health and contraceptive use. I also authored a recent literature review of dual contraceptive method use in the United States for the journal Sexual Health.
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.