title: Use of Dual Methods for Protection from Unintended Pregnancy and Sexually Transmitted Diseases in Adolescent African American Women.
abstract: OBJECTIVE
  To characterize factors associated with dual method contraceptive use in a sample of adolescent women. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We conducted a cross-sectional survey of sexually active African American women aged 14-19 years who attended an urban Title X clinic in Georgia in 2012 (N = 350). Participants completed a computerized survey to assess contraceptive and condom use during the past 2 sexual encounters with their most recent partner. Dual method use was defined as use of a hormonal contraceptive or intrauterine device and a condom. We applied multinomial logistic regression, using generalized estimating equations, to examine the adjusted association between dual method use (vs use of no methods or less effective methods alone; eg, withdrawal) and select characteristics.
  
  
  RESULTS
  Dual methods were used by 20.6% of participants at last sexual intercourse and 23.6% at next to last sexual intercourse. Having a previous sexually transmitted disease (adjusted odds ratio [aOR], 2.30; 95% confidence interval [CI], 1.26-4.18), negative attitude toward pregnancy (aOR, 2.25; 95% CI, 1.19-4.28), and a mother who gave birth as a teen (aOR, 2.34; 95% CI, 1.21-4.52) were associated with higher odds of dual method use. Having no health insurance (aOR, 0.39; 95% CI, 0.18-0.82), 4 or more lifetime sexual partners (aOR, 0.42; 95% CI, 0.22-0.78), sex at least weekly (aOR, 0.54; 95% CI, 0.29-0.99), and agreeing to monogamy with the most recent partner (aOR, 0.40; 95% CI, 0.16-0.96) were associated with decreased odds of dual method use.
  
  
  CONCLUSIONS
  Dual method use was uncommon in our sample. Efforts to increase use of dual methods should address individual and relationship factors.
authors.affiliation: Department of Gynecology and Obstetrics, Emory University, School of Medicine, Atlanta, Georgia. Electronic address: mkottke@emory.edu.
authors.forename: Melissa
authors.initials: M
authors.lastname: Kottke
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Maura K
authors.initials: MK
authors.lastname: Whiteman
authors.affiliation: Department of Behavioral Science and Health Education, Emory University, Rollins School of Public Health, Atlanta, Georgia.
authors.forename: Joan Marie
authors.initials: JM
authors.lastname: Kraft
authors.affiliation: Department of Gynecology and Obstetrics, Emory University, School of Medicine, Atlanta, Georgia.
authors.forename: Peggy
authors.initials: P
authors.lastname: Goedken
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wiener
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Athena P
authors.initials: AP
authors.lastname: Kourtis
authors.affiliation: Department of Behavioral Science and Health Education, Emory University, Rollins School of Public Health, Atlanta, Georgia.
authors.forename: Ralph
authors.initials: R
authors.lastname: DiClemente
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D001294:Attitude to Health; D003131:Combined Modality Therapy; D017280:Condoms / Q000706:statistics & numerical data; D003267:Contraception / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data*; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D005845:Georgia; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data; D016015:Logistic Models; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D003278:Contraceptives, Oral, Hormonal
keywords: Adolescent; African American; Condoms; Dual method use