title: Adherence to dual-method contraceptive use.
abstract: BACKGROUND
  Patient characteristics associated with adherence to dual-method contraceptive use are not known.
  
  
  METHODS
  Project PROTECT was a 24-month-long randomized trial designed to promote the use of dual methods of contraception using an individualized computer-based intervention or enhanced standard care counseling intervention. We analyzed 463 women with follow-up data and examined sustained dual-method use (reported at 2+ interviews).
  
  
  RESULTS
  While 32% initiated dual-method contraceptive use, only 9% reported sustained use. Education increased (RR(adj)=4.42; 95% confidence interval [CI] 1.19-16.42), substance abuse decreased (adjusted relative risk [RR(adj)]=0.49; 95% CI 0.24-0.97), no contraceptive use at baseline decreased (RR(adj)=0.32; 95% CI 0.11-0.92) and contraceptive stage of change increased (RR(adj)=5.04; 95% CI 1.09-23.4) adherence to dual-method use.
  
  
  CONCLUSIONS
  To effectively prevent sexually transmitted diseases and unplanned pregnancies, dual-method use must be consistent and sustained. Future interventions to promote dual-method use should focus on high-risk groups and additional dual-method combinations (e.g., barrier plus intrauterine devices or implants).
authors.affiliation: Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Peipert
authors.forename: Qiuhong
authors.initials: Q
authors.lastname: Zhao
authors.forename: Laura
authors.initials: L
authors.lastname: Meints
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Peipert
authors.forename: Colleen A
authors.initials: CA
authors.lastname: Redding
authors.forename: Jenifer E
authors.initials: JE
authors.lastname: Allsworth
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000379:methods* / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D010349:Patient Compliance; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D012959:Socioeconomic Factors; D055815:Young Adult