Differences between dual-method and non-dual-method protection use in a sample of young African American women residing in the Southeastern United States

Objectives: To characterize dual-method protection users and report the prevalence of dual-method use among young adult African American women residing in the Southeastern United States. Design: Analysis of baseline data from a randomized controlled trial. Setting: A clinic-based sample of young women enrolled in a randomized trial of a human immunodeficiency virus (HIV)-prevention program in Atlanta, Georgia, from June 2005 to June 2007. Participants: African American women aged 14 to 20 years who reported unprotected sexual activity in the past 6 months. Of the eligible adolescents, 94% (N=701) were enrolled in the study and completed baseline assessments. Outcome Measures: Dual-method protection use as well as sociodemographic, individual-level, interpersonal-level, and community-level factors and interpersonal communication skills. Only data from the baseline assessment, before randomization, were used for the analysis. Results: A total of 102 participants (14.6%) were classified as dual-method protection users. After controlling for age and clinic, significant differences between dual-method users and non-dual-method users were found for impulsivity, self-esteem, social support, relationship style, partner communication self-efficacy, and fear of condom negotiation. Conclusions: Dual-method protection use is low. Identification of factors that differentiate dual-method users from non-dual-method users at the individual, interpersonal, and community levels in this young African American sample suggests that HIV, sexually transmitted disease, and unintended pregnancy risk-reduction programs should address factors at each level, not simply the individual level, and that this may involve structural and/or clinical counseling practice changes in clinics that serve young women, to optimally facilitate dual-method protection use among young African American women in the Southeastern United States.