Increasing barrier method use among oral contraceptive users at risk of STDs. What approach is best?

We evaluated whether offering a choice of barrier methods can increase overall barrier method use without decreasing condom use in women using oral contraceptives (OCs) for contraception.

We randomized 167 OC users at risk for sexually transmitted diseases (STDs) into two groups, one receiving male latex condoms only (Condom group), the other receiving both male latex condoms and nonoxynol-9 film (Choice group). All participants received similar hierarchical STD protection counseling. We assessed method use with daily diaries.

The Choice group protected a significantly higher percentage of their coital acts with a barrier method (month 1 to 2: 29% vs. 22%; month 3 to 4: 33% vs. 21%; and month 5 to 6: 35% vs. 19%; adjusted P = 0.012). Condom use in the Choice group was higher as well (adjusted P = 0.036). When we used a transitional multilogistic regression approach to account for differential loss to follow-up in the two groups, results were similar.

Offering a choice of barrier methods increased overall barrier method use without decreasing condom use.