Contraception: It's better to be doubly safe than sorry

The study, by Dr Nick Parr and Dr Stefania Siedlecky from Macquarie University's Demographic Research Group, was published recently in the Australian and New Zealand Journal of Public Health.

It uses survey data from more than 3000 women aged between 18 and 44 about their contraceptive use. The variation in the seven most prevalent contraceptive practices between different age groups, marital status, parity, education level, place of residence, birthplace, and Aboriginal or Torres Strait Islander descent was examined.

Results showed that education, cultural factors arising from ethnic background and the nature of sexual and family relationships were all important factors in determining contraceptive choices.

Two-thirds of respondents were using contraception, including more than 15 per cent who used more than one method. The contraceptive pill was the most widely used method (39 per cent), followed by the condom (28 per cent). Interestingly, more than one-quarter of pill users (28 per cent) were using condoms as well.

"Following its introduction in 1961, the oral contraceptive pill was rapidly adopted by Australian women, while the use of other methods, including condoms, declined," explain Parr and Siedlecky. "However, the arrival of HIV/AIDS in Australia in 1982 focused attention on the public health implications of contraceptive use, particularly the importance of condom use. Consequently condom use increased.

"Condoms are the only contraceptive that protect against sexually transmitted infections and HIV/AIDS for both men and women. However, since the condom alone is less effective as a contraceptive than hormonal methods and intra uterine devices (IUDs), the twin goals of preventing the spread of STIs and preventing unwanted pregnancy through the simultaneous use of both the pill and the condom - so-called dual protection - has been advocated."

While the study indicates that the use of the Pill and the increasing use of dual protection methods have been adopted by most subgroups, it appears a more widespread use of condoms is required among particular groups.

"Women under 25 and students were found significantly more likely to use the combination of pill and condom," say Parr and Siedlecky. "This could reflect a greater number of sexual partners in this demographic and the associated greater need for protection against both STIs and unwanted pregnancy.

"However, rising rates of chlamydia and gonorrhoea indicate there is still a need for more widespread use of condoms, either as a single method or combined with other methods. High rates of STIs and lower levels of condom use, either alone or in combination, may also be an indication of a greater need for education and access among people living in remote Australia or for those of Aboriginal or Torres Strait Islander descent."

Source: Macquarie University