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Cult Health Sex. 2018 Sep;20(9):1006-1022. doi: 10.1080/13691058.2017.1406535. Epub 2017 Dec 12.

Preventing syndemic Zika virus, HIV/STIs and unintended pregnancy: dual method use and consistent condom use among Brazilian women in marital and civil unions.

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a Department of Community Health Sciences , UCLA Fielding School of Public Health , Los Angeles , CA , USA.
b Núcleo de Estudos de População 'Elza Berquó' , Universidade Estadual de Campinas , São Paulo , Brazil.
c School of Social Work , San Diego State University (SDSU) , San Diego , USA.


Syndemic Zika virus, HIV and unintended pregnancy call for an urgent understanding of dual method (condoms with another modern non-barrier contraceptive) and consistent condom use. Multinomial and logistic regression analysis using data from the Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS), a nationally representative household survey of reproductive-aged women in Brazil, identified the socio-demographic, fertility and relationship context correlates of exclusive non-barrier contraception, dual method use and condom use consistency. Among women in marital and civil unions, half reported dual protection (30% condoms, 20% dual methods). In adjusted models, condom use was associated with older age and living in the northern region of Brazil or in urban areas, whereas dual method use (versus condom use) was associated with younger age, living in the southern region of Brazil, living in non-urban areas and relationship age homogamy. Among condom users, consistent condom use was associated with reporting Afro-religion or other religion, not wanting (more) children and using condoms only (versus dual methods). Findings highlight that integrated STI prevention and family planning services should target young married/in union women, couples not wanting (more) children and heterogamous relationships to increase dual method use and consistent condom use.


Condom use; HIV prevention; dual method use; relationship context, Brazil; reproductive health

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