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Behavioral interventions for improving dual-method contraceptive use.

Laureen M Lopez1, Laurie L Stockton, Mario Chen

  • 1Clinical Sciences, FHI 360, 359 Blackwell St, Suite 200, Durham, North Carolina, USA, 27701.

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|April 1, 2014
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Summary
This summary is machine-generated.

Few behavioral interventions effectively improve dual-method contraception use, which combines condoms with other methods for pregnancy and STI prevention. A multifaceted program showed some self-reported success, but overall evidence remains limited.

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Area of Science:

  • Reproductive Health
  • Public Health
  • Behavioral Science

Background:

  • Dual-method contraception, combining condoms with hormonal or intrauterine devices, offers superior protection against pregnancy and sexually transmitted infections (STIs), including HIV.
  • Millions face unmet needs for contraception, particularly in lower-resource settings, increasing risks associated with unprotected sex.

Purpose of the Study:

  • To review comparative studies on behavioral interventions designed to enhance dual-method contraceptive use.
  • To identify effective strategies for preventing both unintended pregnancies and the transmission of HIV/STIs.

Main Methods:

  • A systematic search of multiple databases (MEDLINE, EMBASE, POPLINE, etc.) and clinical trial registries was conducted up to January 2014.
  • Included studies were randomized or non-randomized, focusing on behavioral interventions promoting dual methods (condoms + another contraceptive) for pregnancy and HIV/STI prevention, with outcomes assessed at least three months post-intervention.

Main Results:

  • Four studies met inclusion criteria; interventions varied widely (computer-tailored, phone counseling, case management with peer leadership).
  • A multifaceted program demonstrated a significant increase in self-reported dual-method use (oral contraceptives and condoms) at 12 and 24 months (RR 1.58 and 1.36).
  • Two trials with objective outcomes in clinical settings showed no significant differences in dual-method use, pregnancy, or STI rates between intervention and control groups.

Conclusions:

  • Evidence for the effectiveness of behavioral interventions promoting dual-method contraception is limited.
  • While one multifaceted program showed promise with self-reported data, rigorous studies with objective outcomes are needed.
  • Overall evidence quality was low due to study limitations, including design flaws and high participant dropout rates.