Use of Dual Protection in Botswana

Authors

  • Joan Marie Kraft,

    1. Behavioral Scientist, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-34, Atlanta, GA 30341. E-mail: jik4@cdc.gov.
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  • Christine Galavotti,

    1. Chief, Applied Sciences Branch, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-34, Atlanta, GA 30341
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  • Marion Carter,

    1. Behavioral Scientist, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-34, Atlanta, GA 30341
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  • Denise J. Jamieson,

    1. Medical Officer, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-34, Atlanta, GA 30341.
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  • Lesego Busang,

    1. Monitoring and Evaluation Specialist, African Comprehensive HIV/AIDS Partnership, Gaborone, Botswana.
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  • Douglas Fleming,

    1. At the time the research was conducted, Douglas Fleming was Associate Director for Science, BOTUSA, Centers for Disease Control and Prevention.
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  • Peter H. Kilmarx

    1. Chief, Epidemiology Branch, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention.
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Abstract

High rates of unintended pregnancy and of HIV and other sexually transmitted infections prompt calls for use of “dual-protection” strategies, including consistent condom use or dual-method use. This study examines the use of dual-protection strategies in a sample of 15–49-year-old men and women in Botswana in 2003. Half of sexually active respondents reported consistent condom use in the past year; 2.5 percent reported dual-method use. Multiple logistic regression analyses showed that urban residence, less than a ten-year age difference between partners, discussing HIV and contraception with one's partner, not intending to have a child in the next year, having no children, being in a relationship where one or both partners have additional concurrent partners, and supportive condom norms were associated with dual protection—that is, with consistent condom or dual-method use. In the context of high HIV prevalence, concerns about disease prevention likely influence contraception, and interventions should address childbearing desires and sexual risk simultaneously.

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