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Fam Plann Perspect. 1995 Mar-Apr;27(2):74-8.

Combined use of condoms with other contraceptive methods among inner-city Baltimore women.

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Baltimore City Health Department, Department of Health Policy Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD, USA.


Data from a street survey conducted among 717 women aged 17-35 in two inner-city Baltimore communities in 1991-1992 indicate that 17% of the entire sample, 38% of women using the pill and 11% of users of methods other than the pill used a condom in addition to another method the last time they had intercourse. Although adolescents reported the highest rate of combined condom and pill use (22% of 17-19-year-olds), condom use was significantly associated with pill use among adult women (odds ratio of 1.57) but not among adolescents (odds ratio of 1.03). Condom use was negatively associated with use of methods such as the diaphragm, the IUD, the implant and the sponge (odds ratio of 0.21) among both adolescents and adults. Logistic regression analyses show that positive attitudes toward safer sex, ever having refused sex without a condom and believing in condom efficacy all significantly predicted use of the condom with another method. Having ever been tested for HIV was negatively related to combined use, while behavioral risk factors showed no association.


In 1991 and 1992, in Baltimore, Maryland, interviews were conducted with 717 sexually active women aged 17-35 living in two inner-city neighborhoods to determine the prevalence of combined use of condoms with other contraceptive methods and the demographic, attitudinal, and behavioral correlates of combined use. The typical woman was Black (96%), had never been married (84%), and had at least completed high school (65%). 45% were currently employed. 49% had made changes in their personal behavior since learning about AIDS. More than 80% said that they could do a lot to prevent HIV infection. 24% had at least one personal risk factor for HIV in the last year. 10% had partners who took part in high-risk behaviors in the last six months. Both personal risk factors and partner risk factors were associated with each other (odds ratio [OR] = 5.1). Oral contraceptives (OCs) were the most common method used during last intercourse (40.1%) followed by condoms (33.2%). 38.1% used the condom with OCs. 10.7% used the condom with any other contraceptive method but OCs. Combined use was highest among teenagers (24.1% vs. 7.4-15%) and OC users (41.6% vs. 32.1-36.8%). Condom use had a positive association with OC use among adult women (20-35 years) (OR = 1.57) but not among teenagers. Spermicide use was also associated with condom use (OR = 3.01). Use of diaphragms, sponges, the IUD, and the levonorgestrel implant had a negative relationship with condom use (OR = 0.19, 0.14, 0.32, and 0.35, respectively). Positive attitudes towards safer sex (OR = 1.39), ever having refused sex without a condom (OR = 7.09), and greater belief in condom efficacy (OR = 1.89) predicted combined use. Ever having been tested for HIV predicted non-use (OR = 0.53). Personal and partner behavioral risks for STDs and HIV did not predict combined method use.

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