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J Sex Transm Dis. 2013;2013:540789. doi: 10.1155/2013/540789. Epub 2013 Jun 20.

Dual Protection and Dual Methods in Women Living with HIV: The Brazilian Context.

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Department of Community Health Sciences, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, 26-070 CHS, Los Angeles, CA 90095-1772, USA.
Population Studies Center (NEPO), University of Campinas (UNICAMP), Cidade Universitaria Zeferino Vaz., Avenida Albert Einstein 1300, Caixa Postal 6166, 13081-970 Campinas, SP, Brazil.
Epidemiology Program, National School of Public Health, Oswaldo Cruz Foundation (FIOCRUZ), Rua Leopoldo Bulhões 1480, 21041-210, Rio de Janeiro, RJ, Brazil.


The cooccurrence of HIV and unintended pregnancy has prompted a body of work on dual protection, the simultaneous protection against HIV and unintended pregnancy. This study examines dual protection and dual methods as a risk-reduction strategy for women living with HIV. Data are from a cross-sectional sample of HIV-positive women attended in Specialized STI/AIDS Public Health Service Clinics in 13 municipalities from all five regions of Brazil 2003-2004 (N = 834). Descriptive techniques and logistic regression were used to examine dual protection among women living with HIV. We expand the definition of dual protection to include consistent condom use and reversible/irreversible contraceptive methods, we test the dual methods hypothesis that women who use dual methods will use condoms less consistently than women who use only condoms, and we identify predictors of dual protection. Dual protection is common in our sample. Women who use dual methods have lower odds of consistent condom use than women who only use condoms. Among dual method users, we find that women who use an irreversible method use condoms more consistently than women who use a reversible method. Women on ART and with an HIV-serodiscordant partner have greater odds of consistent condom use than their counterparts.

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