Are dual-method messages undermining STI/HIV prevention?

Adolescent girls and young women who are at risk for unplanned pregnancy and sexually transmitted infection (STI), including HIV, are frequently counseled to use a hormonal contraceptive to protect against the former and condoms to protect against the latter, for example, American College of Obstetricians and Gynecologists, 2011. The present paper reviews the literature on multiple risk messages, compliance with this dual-use recommendation, predictors of dual use, and interventions developed to encourage dual use. Data indicate that simultaneous use of these two methods is not common, and that efforts to encourage dual use have not yielded promising results. An alternative is to recommend condom use alone, since condoms protect very well against STI and HIV, and quite well against pregnancy when used consistently and correctly. The availability of emergency contraception is relevant here. Research utilizing a randomized controlled trial is recommended.