Family planning providers' perspectives on dual protection.
BACKGROUND
Family planning providers can play an important role in helping women to identify their risk of HIV and other sexually transmitted diseases (STDs) and to adopt preventive measures. In-depth investigation of providers' attitudes about approaches to STD risk assessment, contraceptive counseling and dual protection--concurrent protection from STDs and unintended pregnancy--has been limited.


METHODS
In semistructured interviews conducted in 1998, 22 health care providers from a large New York City agency offering contraceptive and STD services described how they balanced STD and pregnancy concerns, viewed risk assessment and assessed various contraceptive methods.


RESULTS
STD prevention was seen as an integral part of family planning counseling, and most providers believed that risk assessment should be conducted universally. Providers viewed dual protection as use of condoms along with an effective contraceptive; few advocated use of the male or female condom alone. The female condom was believed to be a disease prevention method of last resort and was considered appropriate only for specific groups of women. Although providers lacked understanding about the effectiveness of the female condom and how to counsel clients concerning its use, they expressed interest in learning more.


CONCLUSIONS
Training is needed to reduce providers' negative perceptions of the female condom and to reinforce the importance of individualized counseling tailored to women's specific circumstances. Studies are needed on how to encourage family planning providers to promote male and female condoms as effective contraceptive methods.
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, USA. jmantell@cnvlz.com
Joanne E
JE
Mantell
Susie
S
Hoffman
Theresa M
TM
Exner
Zena A
ZA
Stein
Kim
K
Atkins
D000328:Adult; D000739:Anecdotes as Topic; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D019111:Single-Use Internal Condom / Q000706:statistics & numerical data; D003376:Counseling; D005193:Family Planning Services / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D006801:Humans; D008297:Male; D009519:New York City; D011322:Primary Prevention / Q000379:methods*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D011795:Surveys and Questionnaires