Barcelona 2013
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| Abstract #240 - E-Posters English | ||||
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Session: 50.110: E-Posters English (Poster) on Sunday in Chaired by Authors: Presenting Author: Mrs Nathalie Beltzer - ORS Île-de-france, France |
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| Additional Authors: Dr. Jordi Casabona, Sra Cristina Sanclemente, Dra. Anna Esteve, Dra. Victoria Gonzalez, Grupo HIVITS TS, | ||||
| Aim: Despite a large range of available contraceptive methods and a frequent use of condoms at first intercourse, increasing STIs prevalence and abortion rate during the last 15 years are indicative of contraceptive failure. Discontinuations of contraceptive method are frequent for continuing relationships either due to condom abandonment or to method switching, mainly from condom to others methods (oral pill). The aim of our study was to identify the individual and relational factors associated with condom abandonment and to propose strategies to prevent unintended pregnancies and HIV or others STIs. | ||||
| Method / Issue: Data were obtained from a KABP survey carried out in France by telephone in 2010. Participants were selected based on a two stage probability sampling design. We restricted our analyses on 862 men and 741 women aged 18 to 49 years who initiated a sexual relationship in the two years prior to the interview date and who were asked specific questions regarding their new relationships and their new partner. Only heterosexual relationships were considered. The following indicators were used: duration of relationship, type of partner (regular or casual), partners? age difference, dual method use, reason to use condom, condom discontinuation, and contraceptive relay. Logistic regressions were performed accounting for the sampling. | ||||
| Results / Comments: Up to 12% of men and women did not protect their first intercourse with a new partner and 80% used a condom, including 24% of men and 37% of women in association with another contraceptive, mainly the pill. Condom was more used in younger and better educated men (OR 2.4 [1.2-4.7]) and women (2.5 [1.1-5.5]). The longer the relationship, the higher was the abandonment: 25% after 3 months and more than 50% after 6 months. Women stopped using condom more frequently than men: 50% vs 42% (p=0.01), amongst whom respectively 44% and 25% without replacing it by any other contraceptive method. This lack of contraceptive relay increased with age in men and women and was lower for higher educated men (OR 0.3 [0.1-0.9]) and not always motivated by a desire of pregnancy. Relationships characteristics were associated with condom abandonment rate: lower when respondent was still engaged with another partner, when partner was considered as casual, and when not living with him/her; higher when dual contraception was used at first intercourse (OR 1.6 [1.01-2.4] for men). Abandonment was also lower when reasons given to use condom were both prevention of STI and contraception as opposed to prevention only (OR 0.5 [0.3-0.9] for men and OR 0.4 [0.2-0.8] for women). | ||||
| Discussion: Condoms use was frequently given up in continuing relationships. Its abandonment was quite often not accompanied with another contraceptive relay. Those unprotected intercourses were more frequent when condom at first acts of intercourse was mainly used as preventive rather than for contraceptive purpose. These results question the dichotomy often made between HIV campaigns based on condom use and campaigns to reduce unintended pregnancies. Preventive strategies have to be adapted to promote condoms as one available contraceptive option. | ||||
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