Higgins Jenny A, Cooper Anne D
Heilbrunn Department of Population and Family Health, Columbia University, New York, NY 10032, USA.
Sex Health. 2012 Mar;9(1):73-80. doi: 10.1071/SH11004.
Use of condoms in conjunction with other contraceptive methods has multiple benefits: prevention of unintended pregnancy, protection against sexually transmissible infections (STI), and sequentially, defence against the threat of infertility. However, few reviews compare dual method use prevalence or trends or systematically review the facilitators and barriers of dual method use across multiple studies.
The authors review the literature on trends and covariates of dual method use in the USA among both nationally representative and smaller samples.
Although dual method use prevalence estimates vary widely across study populations, nationally representative estimates are consistently lower than Western European countries, who in turn report lower rates of unintended pregnancies and STI. The majority of published work on dual method use focuses on adolescents. Prior studies have associated dual method use with a range of individual-level factors: socio-demographic variables, such as younger age; STI risk behaviours and risk perception; relationship variables, such as number of partners, relationship length, and partner support of condoms; and educational factors, such as prior exposure to HIV prevention messages.
Although dual method use appears to be on the rise, especially among adolescents and young adults, US rates are comparatively low and leave much room for improvement. This review identifies several populations most in need of intervention. However, we encourage public health practitioners to evolve beyond individual-level studies and interventions to focus on the relational, socio-cultural, and structural influences on dual method use. Dual use promotion programs and policies should also equally target men and women, adolescents and adults.
将避孕套与其他避孕方法结合使用有多种益处：预防意外怀孕、预防性传播感染（STI），进而抵御不孕不育的威胁。然而，很少有综述比较双重避孕方法的使用流行率或趋势，也很少有综述系统地回顾多项研究中双重避孕方法使用的促进因素和障碍。
作者回顾了美国全国代表性样本和较小样本中双重避孕方法使用的趋势及相关因素的文献。
尽管不同研究人群中双重避孕方法使用流行率的估计差异很大，但全国代表性估计始终低于西欧国家，而西欧国家的意外怀孕率和性传播感染率又较低。关于双重避孕方法使用的大多数已发表研究都集中在青少年身上。先前的研究将双重避孕方法的使用与一系列个体层面的因素联系起来：社会人口统计学变量，如年龄较小；性传播感染风险行为和风险认知；关系变量，如性伴侣数量、关系持续时间以及伴侣对避孕套的支持；以及教育因素，如先前接触过艾滋病预防信息。
尽管双重避孕方法的使用似乎在增加，尤其是在青少年和年轻人中，但美国的使用率相对较低，仍有很大的改进空间。本综述确定了几个最需要干预的人群。然而，我们鼓励公共卫生从业者超越个体层面的研究和干预，关注对双重避孕方法使用的关系、社会文化和结构影响。双重避孕方法推广计划和政策也应平等地针对男性和女性、青少年和成年人。
