Cushman L F, Romero D, Kalmuss D, Davidson A R, Heartwell S, Rulin M
Center for Population and Family Health, Columbia University School of Public Health, New York, New York, USA.
Fam Plann Perspect. 1998 Sep-Oct;30(5):240-3.
Women who rely on long-term hormonal contraception may neglect to use condoms, and thus increase their risk of contracting sexually transmitted diseases, including AIDS.
Data from a prospective, multisite study were collected to examine the probability of condom use among 1,073 new users of either the contraceptive implant or injectable; users were interviewed when they accepted their method and again six months to one year later. Multivariate logistic regression analyses identified factors that significantly predicted the likelihood of dual method use.
Condom use dropped markedly among women who adopted long-term hormonal contraception. The proportion who always used condoms in the previous three months fell from 21% at the time of adoption to 11% at follow-up. Among women with one sexual partner, this decrease was from 20% to 10%; however, among those with more than one partner, use increased from 25% to 31%. The factors significantly predicting dual method use included previous condom use (odds ratio of 2.5), receipt of AIDS-specific counseling (odds ratio of 1.6), the perception of being at some risk of AIDS at baseline (odds ratio of 1.4) and having had more than one sexual partner over the study period (odds ratio of 5.4). In addition, injectable users, teenagers and black women were more likely than other women to use condoms with their hormonal method.
Although condom use among all women declined markedly once they initiated long-term hormonal contraception, frequency of condom use varied by subgroup and was associated with several factors. Most importantly, women with more than one sexual partner and those who received a message during counseling on the need to continue using condoms were more likely than others to use condoms in conjunction with the implant or injectable.
依赖长期激素避孕的女性可能会忽略使用避孕套，从而增加感染包括艾滋病在内的性传播疾病的风险。
收集来自一项前瞻性多地点研究的数据，以检查1073名新使用避孕植入物或注射剂的使用者使用避孕套的可能性；在使用者接受避孕方法时以及六个月至一年后再次对其进行访谈。多变量逻辑回归分析确定了显著预测同时使用两种方法可能性的因素。
采用长期激素避孕的女性中避孕套使用显著下降。在前三个月一直使用避孕套的比例从采用时的21%降至随访时的11%。在只有一个性伴侣的女性中，这一比例从20%降至10%；然而，在有多个性伴侣的女性中，使用率从25%升至31%。显著预测同时使用两种方法的因素包括以前使用过避孕套（优势比为2.5）、接受过艾滋病专项咨询（优势比为1.6）、在基线时认为有感染艾滋病的一定风险（优势比为1.4）以及在研究期间有多个性伴侣（优势比为5.4）。此外，注射剂使用者、青少年和黑人女性比其他女性更有可能在使用激素避孕方法时同时使用避孕套。
尽管所有女性一旦开始长期激素避孕，避孕套使用都显著下降，但避孕套使用频率因亚组而异，且与多个因素相关。最重要的是，有多个性伴侣的女性以及在咨询中收到关于需要继续使用避孕套信息的女性比其他人更有可能在使用植入物或注射剂时同时使用避孕套。
