From the *Department of Community and Family Health, College of Public Health, and †The Chiles Center, University of South Florida, Tampa, FL.
Sex Transm Dis. 2017 Jul;44(7):423-427. doi: 10.1097/OLQ.0000000000000620.
Long-acting reversible contraception (LARC) is extremely effective in preventing pregnancy; however, it does not provide sexually transmitted infection (STI) prevention. Therefore, dual use is recommended for the prevention of STIs, in addition to pregnancy, by using LARC methods with condoms. This study assessed factors associated with LARC only use and dual-LARC and condom use among college women.
The National College Health Assessment-II Fall 2012 to 2013 was used for this analysis. The analytic sample was restricted to women who used a LARC method (ie, intrauterine device or implant) (N = 1658). The main outcome was dual method use, LARC and condom, at last sex. An adjusted logistic regression model assessed sociodemographic factors (age, relationship, race), health care utilization (routine gynecological examination), and sexual behavior (number of partners) as factors associated with dual condom-LARC use at the last time of vaginal-sex. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated.
Among women reporting LARC use, 24% used a condom. Dual users were less likely to have only 1 sexual partner (adjusted PR [aPR], 0.66; 95% CI, 0.54-0.81) and be in a relationship. Dual users were more likely than LARC-only users to be Hispanic (aPR, 1.34; 95% CI, 1.01-1.78), black (aPR, 1.40; 95% CI, 1.07-1.83), and biracial/multiracial (aPR, 1.38; 95% CI, 1.10-1.73).
These findings illustrate differences between dual-condom LARC and LARC-only college users. It is likely that relationship status and number of partners influences perceived risk for STIs and decision making for dual use among this population.
长效可逆避孕方法（LARC）在避孕方面非常有效，但它并不能预防性传播感染（STI）。因此，建议将 LARC 方法与 condom 联合使用，以实现除避孕以外的 STI 预防，这种方法被称为双重使用。本研究评估了大学女性中仅使用 LARC 方法和双重使用 LARC 方法和 condom 预防怀孕和 STI 的相关因素。
本研究使用了 2012 年至 2013 年全国大学生健康评估 II 秋季调查的数据。分析样本仅限于使用 LARC 方法（即宫内节育器或植入物）的女性（N=1658）。主要结局是上次阴道性行为时的双重方法使用，即 LARC 和 condom。采用调整后的逻辑回归模型评估了社会人口因素（年龄、关系、种族）、医疗保健利用（常规妇科检查）和性行为（性伴侣数量）与上次阴道性行为时同时使用 condom-LARC 方法的关联。估计了患病率比（PR）和 95%置信区间（CI）。
在报告使用 LARC 的女性中，有 24%使用 condom。双重使用者不太可能只有 1 个性伴侣（调整后的 PR[aPR]，0.66；95%CI，0.54-0.81），并且处于恋爱关系中。与仅使用 LARC 的女性相比，双重使用者更有可能是西班牙裔（aPR，1.34；95%CI，1.01-1.78）、黑人（aPR，1.40；95%CI，1.07-1.83）和混血/多种族（aPR，1.38；95%CI，1.10-1.73）。
这些发现说明了双重 condom-LARC 和仅使用 LARC 的大学使用者之间的差异。在这一人群中，关系状况和性伴侣数量可能会影响对 STI 的感知风险，并影响双重使用的决策。
