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

Background: Use of condoms with hormonal contraceptive methods (dual use) is recommended for adolescents at increased risk for sexually transmitted infections and pregnancy. Goal: 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. Study Design: 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. Results: 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. Conclusion: Dual use has increased but remains low, especially among those most at risk.