Adherence to dual-method contraceptive use

Abstract

Background: Patient characteristics associated with adherence to dual-method contraceptive use are not known.

Study design: 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.

Conclusion: 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).