Anderson John E, Santelli John, Gilbert Brenda Colley
Division of HIV/AIDS Prevention, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Sex Transm Dis. 2003 Sep;30(9):719-22. doi: 10.1097/01.OLQ.0000078628.84288.66.
Use of condoms with hormonal contraceptive methods (dual use) is recommended for adolescents at increased risk for sexually transmitted infections and pregnancy.
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.
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.
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.
Dual use has increased but remains low, especially among those most at risk.
对于性传播感染和怀孕风险增加的青少年，建议将避孕套与激素避孕方法联合使用（双重使用）。
本研究旨在衡量青少年中双重使用的程度，估计1991 - 2001年间双重使用的趋势，评估2001年与双重使用相关的因素，并为预防项目提供有用信息。
我们使用了1991 - 2001年间对9至12年级学生进行的6次青少年风险行为调查。每次调查都是一个独立的、具有全国代表性的样本。样本量从10904到16262不等，总体回复率从60%至70%不等。我们使用双重使用的线性逻辑回归模型，对调查年份进行分析，并对年级、性别和种族/族裔群体进行统计学控制，以估计1991 - 2001年期间双重使用的趋势，并通过卡方分析评估双重使用的相关因素。
在1991 - 2001年期间，双重使用显著增加，从1991年的3.2%（95%置信区间，±0.7%）增至2001年的7.2%（±0.8%）。在此期间，避孕套的使用增加，而避孕药的使用没有变化。2001年，所有激素避孕方法（避孕药或注射剂）使用者中有32%（±2.6%）也使用避孕套。一些类别的学生双重使用率较高：白人学生（8.9%±1.2%）、12年级学生（9.2%±1.5%）以及17岁及以上的学生（8.8%±1.3%）。较高的双重使用率与性或药物使用风险行为的增加无关。
双重使用有所增加，但仍然较低，尤其是在那些风险最高的人群中。
