Abstract
Objectives
Male condom use in conjunction with other contraceptives increases protection against
pregnancy and sexually transmitted infections. However, few analyses contextualize
dual method use within the sexual episode, include reports from men or explore gendered
patterns in reporting.
Study design
We analyzed dual method use patterns using a nationally representative dataset of
18–44 years old in the US (N=404 men, 416 women). Respondents indicated contraceptive methods used at last penile–vaginal
intercourse, condom practices and relationship and sexual information about that particular
partner.
Results
More than one-in-three penile–vaginal intercourse episodes (40%) involved male condom
use: 28% condom only and 12% condom plus a highly effective method. Dual method reporting
did not differ significantly by gender. Among dual method users, only 59% reported
condom use during the entire intercourse episode, while 35% began intercourse without
one and 6% removed the condom during intercourse. A greater proportion of men than
women reported incorrect use of condoms (49% versus 35%), though this difference was
not statistically significant. Only 50% of dual method users reported condom use in
all of their last 10 intercourse episodes.
Conclusions
Many people classified as “dual users” in previous studies may not be using dual methods
consistently or correctly. 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 method use, they can provide consistent contraceptive
estimates and may be more likely to report condom practices such as late application
or early removal.
Implications statement
Many US women and men reporting dual method use also reported late application and
early removal of condoms, as well as multiple condom-less prior sexual acts with that
partner. Clinicians may wish to inquire how and how often clients use condoms; they may also wish to provide condom instruction and/or tips
on better integrating condoms into the sexual experience with one's partner.
Keywords
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Article info
Publication history
Published online: June 12, 2014
Accepted:
June 5,
2014
Received in revised form:
May 28,
2014
Received:
February 12,
2014
Footnotes
☆No conflicts of interest need to be noted.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
