| Popis: |
Few U.S. women protect themselves against both pregnancy and sexually transmitted diseases (STDs) by using an efficient contraceptive method and a condom. Understanding the factors that influence dual-method use could help improve interventions aimed at encouraging protective behaviors.Interviews were conducted with 552 low-income women at risk of HIV who attended public health or economic assistance facilities in Miami in 1994 and 1995. Multinomial logit analyses were used to determine the influence of women's background characteristics, perceived vulnerability to pregnancy and AIDS, and relationship characteristics on the odds of dual-method use.Overall, 20% of the women used dual methods. Women who were not married, who worried about both pregnancy and AIDS, who had ever had an STD, who were confident they could refuse a sexual encounter in the absence of a condom and who made family planning decisions jointly with their partner were the most likely to use dual methods rather than a single method (odds ratios, 2.0-3.5); those who considered the condom only somewhat effective in preventing AIDS or who shared economic decision-making with their partner were the least likely to use dual methods rather than a single method (0.5-0.6). The results were generally similar in analyses examining the odds of dual-method use involving an efficient contraceptive, except that black and Hispanic women were significantly more likely than whites to use condoms in conjunction with efficient contraceptives (3.3-7.1).Both women's individual characteristics and the context of their sexual relationships influence whether they simultaneously protect themselves from pregnancy and HIV. The involvement of male partners in family planning decision-making and women's control over economic decision-making ensure greater protection against HIV infection.Promotion of condom use among women who use efficient contraception is essential to protect them from sexually transmitted diseases (STDs), including HIV, as well as pregnancy. However, fear of negative reactions from a male partner may prohibit dual method use among women who are economically dependent on men. To understand the factors that influence dual method use, interviews were conducted with 522 low-income US women at risk of HIV who attended 21 public health, family planning (FP), and STD clinics or economic assistance centers in Miami, Florida (US), in 1994-95. 54% were concerned about both pregnancy and AIDS; 32% were worried about AIDS only and 5% about pregnancy only. 20% of respondents reported dual method use; overall, 36% of women used condoms (either alone or along with another method). The rate of dual method use was 16% among Whites, 24% among Blacks, and 21% among Hispanics. The likelihood of dual method use was significantly enhanced (odds ratio, 2.0-3.5) among women who were not married, worried about both pregnancy and AIDS, had ever had an STD, were confident they could refuse sex with a man who would not use a condom, and made FP decisions jointly with their partner. Women who regarded condoms as only somewhat effective in preventing HIV infection or who shared economic decision-making with their partner rather than making such decisions alone were least likely to use dual methods. Black and Hispanic women were significantly more likely than White women to use condoms in conjunction with efficient contraception. |
