Case records and commentaries in obstetrics and gynaecology

Abstract

Background: Dual method use is increasingly being advocated for the simultaneous prevention of undesired pregnancy and sexuallv transmitted infections including HIV/AIDS. Objective: To determine knowledge, attitude and practice of dual method of contraception among family planning clients. Design: Cross-sectional study Setting: Kenyatta National Hospital's Family Welfare Clinic. Subjects: Reproductive age women accessing family planning services at the hospital. Materials and methods: A total of 270 women who had been on a non-barrier method of family planning for at least 6 months were interviewed between the months of October 2006 and January 2007. Results: The respondents' knowledge on whether HIV/STDS can be acquired together with an undesired pregnancy in one single intercourse was high (91.1%). The knowledge on dual method use was low at 9.9% though knowledge of use of condoms as dual protection was high at 82.2%. There was a positive attitude towards dual method use (97%), however only 30% would consider using a condom along with their current family planning method. Those employed, those not married and those who considered themselves at risk of HIV/STDS were more likely to consider using dual method (p=0.003, 0.013 and 0.012 respectively). Only 38.1% of respondents thought their partners would not approve condom use. The use of dual method was very low with only 8.9% using the dual method consistently throughout their sexual intercourse one month prior to interview. Only 23.7% had used the dual method at some time in the year preceding the interview while 14.1% had used the method in their most recent sexual intercourse. Those who were not married, those who do not live together with their partners and those who had a history of abortion were more likely to use dual method (p=<0.001, p=<0.001, p=0.040 respectively). The main facilitatory reasons for dual method use was when the respondents wished to protect themselves (38.3%), while the main reason given for non-use of the dual method was that they had a steady relationship, trusted partner or were married (58.9%)

Conclusion: Despite many people knowing that pregnancy and HIV/STD can be acquired simultaneously very few know and actually use the dual method of protection and this is more often when they want to protect themselves.