Contraceptive method and condom use among women at risk for HIV infection and other sexually transmitted diseases -- selected U.S. sites 1993-1994.

An analysis of data from the Prevention of HIV in Women and Infants Demonstration Project indicated that many US women who are protected from pregnancy are unprotected from sexually transmitted diseases (STDs). Included in the analysis were 952 women at risk of human immunodeficiency virus (HIV) but not HIV positive recruited from 8 sites in California Oregon and Pennsylvania during 1993-94. 564 women (59%) reported sex with a main partner and 580 (61%) reported sex with a casual partner in the preceding 30 days; condoms were used in 44% and 71% of these sexual encounters respectively. Among women whose stated contraceptive method was condoms 108/277 (39%) had not used a condom at last intercourse with their main partner and 73/336 (22%) had not used a condom at last intercourse with a casual partner. Among women who used hormonal contraception 74/105 (70%) had not used a condom at last intercourse with their main partner and 32/76 (42%) had not used a condom at last intercourse with a casual partner. Among women who were surgically sterilized 127/173 (73%) had not used a condom at last intercourse with their main partner and 58/157 (37%) had not used a condom with their casual partner. Overall these findings suggest that condom use is unacceptably low among women who believe they are effectively preventing pregnancy. A dual approach (e.g. hormonal contraceptives plus condoms) should be advocated for women at risk of both unintended pregnancy and STDs.