Dual contraception or dual method refers to the use of condom with hormonal
contraceptives or an intrauterine device to ensure enhanced protection and prevention of
both unintended pregnancies and STI/HIV. When used consistently and correctly, it is
capable of ensuring healthy sexual life devoid of the challenges of morbidity and mortality
associated with unprotected sex. Notwithstanding, the extent of use of dual
contraceptivesmethod use in Ghana is not known. The overarching objective of this
research was to assess the knowledge, extent of use, reasons for use and factors affecting
dual contraception among sexually active females within the ages of 18 – 49 years in the
La-Nkwantanang-Madina Municipality.
This was a community based cross-sectional survey that involved the use of multi-stage
random sampling to select study participants. Structured questionnaires were administered
to elicit information on the use of dual contraception during their last sexual encounter,
knowledge, and challenges of access to dual contraception services. Data were entered into
Microsoft Excel 2013 and analyzed with Stata version 13. Bivariate and multivariate
logistic regression analysis were performed to establish associations between variables.
The prevalence of dual contraceptive utilization was found to be 12.9% among sexually
active females. Among the never married (single) dual contraceptive utilization was 11.9%,
married 15.0% and among the separated, divorced and widowed prevalence was 13.0%.
Prevalence of general contraceptive use was 54.2% with 48.3% among the never married
and 60.0% among the married. Controlling for age, marital status and occupation, the odds
of a respondent using dual method of contraception is 3.3 times as great as the odds of that
respondent using a condom [aOR = 3.3 (95% CI = 1.41 – 7.50), p<0.05] and the odds of a
University of Ghana http://ugspace.ug.edu.gh
v
respondent adopting dual method of contraception is about 5.7 times as great as the odds
of the person using the pill [aOR = 5.7 (95% CI = 2.51 – 13.08), p<0.001]. Notable reasons
for contraceptive preference included ease of obtaining, ease of use, reduced or no side
effect and partner preference. Knowledge and use of dual method of contraception is low.
Many of the factors that affect the choice and utilization of dual contraception are mainly
based on individual preferences and perceptions. Most people would not use any barrier
method because they could prevent pregnancy using hormonal contraceptives such as the
pill without compromising on their sexual pleasures. This sexual practice increases the risk
of Sexually Transmitted Infections (STI) and HIV.
Knowledge on dual contraception is low among study participants. Respondents
contraceptive preference (choice and use) were based largely on ease of use of the method,
the ability to easily obtain the contraceptive and contraceptives that will not reduce their
sexual pleasure. Less than 15% consider prevention of STI as a priority for contraceptive
use. The large majority will consider prevention of pregnancy as the main focus for
contraceptive use. It is recommended that education on contraception should be increased
with improved strategies.