Abstract
Background Patient characteristics associated with adherence to dual-method contraceptive use are not known. Study Design Project PROTECT was a 24-month-long randomized trial designed to promote the use of dual methods of contraception using an individualized computer-based intervention or enhanced standard care counseling intervention. We analyzed 463 women with follow-up data and examined sustained dual-method use (reported at 2+ interviews). Results While 32% initiated dual-method contraceptive use, only 9% reported sustained use. Education increased (RR adj=4.42; 95% confidence interval [CI] 1.19–16.42), substance abuse decreased (adjusted relative risk [RR adj]=0.49; 95% CI 0.24–0.97), no contraceptive use at baseline decreased (RR adj=0.32; 95% CI 0.11–0.92) and contraceptive stage of change increased (RR adj=5.04; 95% CI 1.09–23.4) adherence to dual-method use. Conclusion To effectively prevent sexually transmitted diseases and unplanned pregnancies, dual-method use must be consistent and sustained. Future interventions to promote dual-method use should focus on high-risk groups and additional dual-method combinations (e.g., barrier plus intrauterine devices or implants).
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