Abstract
Purpose
To describe women's condom use patterns over time and assess predictors of dual method
use 12 months after initiating hormonal contraceptives.
Methods
We conducted a prospective cohort study among women aged 15–24 years initiating oral
contraceptive pills, patch, ring, or depot medroxyprogesterone and attending public
family planning clinics. Participants completed questionnaires at baseline and 3,
6, and 12 months after enrollment. We used multivariable logistic regression to assess
baseline factors associated with dual method use at 12 months among 1,194 women who
were sexually active in the past 30 days.
Results
At baseline, 36% were condom users, and only 5% were dual method users. After initiation
of a hormonal method, condom use decreased to 27% and remained relatively unchanged
thereafter. Dual method use increased to a peak of 20% at 3 months but decreased over
time. Women who were condom users at baseline had nearly twice the odds of being a
dual method user at 12 months compared with nonusers (adjusted odds ratio [AOR] =
2.01, 95% CI: 1.28–3.14). Women who believed their main partner thought condoms were
"very important," regardless of perceived sexually transmitted infection risk or participant's
own views of condoms, had higher odds of dual method use (AOR = 2.89, 95% CI: 1.47–5.71).
Conclusions
These results highlight a potential missed opportunity for family planning providers.
Providers focus on helping women initiate hormonal methods, however, they may improve
outcomes by giving greater attention to method continuation and contingency planning
in the event of method discontinuation and to the role of the partner in family planning.
Keywords
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Article info
Publication history
Published online: October 09, 2012
Accepted:
August 2,
2012
Received:
December 12,
2011
Identification
Copyright
© 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
