Use of dual protection in Botswana.

High rates of unintended pregnancy and of HIV and other sexually transmitted infections prompt calls for use of "dual-protection" strategies, including consistent condom use or dual-method use. This study examines the use of dual-protection strategies in a sample of 15-49-year-old men and women in Botswana in 2003. Half of sexually active respondents reported consistent condom use in the past year; 2.5 percent reported dual-method use. Multiple logistic regression analyses showed that urban residence, less than a ten-year age difference between partners, discussing HIV and contraception with one's partner, not intending to have a child in the next year, having no children, being in a relationship where one or both partners have additional concurrent partners, and supportive condom norms were associated with dual protection--that is, with consistent condom or dual-method use. In the context of high HIV prevalence, concerns about disease prevention likely influence contraception, and interventions should address childbearing desires and sexual risk simultaneously.