Adolescent dual use of condoms and hormonal contraception: trends and correlates 1991-2001

Use of condoms with hormonal contraceptive methods (dual use) is recommended for adolescents at increased risk for sexually transmitted infections and pregnancy.

The goal was to measure the extent of dual use among adolescents, to estimate trends in dual use 1991-2001, to assess factors associated with dual use in 2001, and to develop information useful for prevention programs.

We used 6 Youth Risk Behavior Surveys of 9th-12th graders conducted 1991-2001. Each survey was an independent, nationally representative sample. Sample sizes ranged from 10,904 to 16,262, and overall response rates ranged from 60-70%. We estimated trends in dual use for the 1991-2001 period using linear logistic regression models of dual use on year of survey controlling statistically for grade, sex, and race/ethnic group, and evaluated correlates of dual use with chi-squared analysis.

Dual use increased significantly throughout 1991-2001, from 3.2% (95% confidence interval, +/- 0.7%) in 1991 to 7.2% (+/- 0.8%) in 2001. During this period, condom use increased and pill use did not. In 2001, 32% (+/- 2.6%) of all users of hormonal methods (pill or injection) also used condoms. Students in a number of categories had higher rates of dual use: those who were white (8.9% +/- 1.2%), 12th graders (9.2% +/- 1.5%), and those aged 17 and older (8.8% +/- 1.3%). Greater dual use was not associated with increased sexual or drug use risk behaviors.

Dual use has increased but remains low, especially among those most at risk.