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    C. Dual Protection

    - Prevention of Unintended pregnancy and Sexually Transmitted Diseases; the role of condoms and emergency contraception

    Dual Protection:
    - What is Dual Protection?
    Assuring dual protection involves both choosing a family planning method and making decisions about one's sexual behavior at the same time.

    - Providing the opportunity for an informed decision is a patient’s right and a provider’s responsibility. This includes:
    - Awareness of personal STD risks, and their consequences
    - Awareness of personal unintended pregnancy risk
    - Awareness of options for dual protection, and advantages and disadvantages
    - Accurate information about dual protection

    “Before clients decide on a method, however, providers should be sure to tell them that condoms are the only contraceptive method that protects against STIs.”

    - “Anyone with a risk factor for STIs should use dual protection: condoms to protect against STIs/HIV in combination with another effective method to protect against pregnancy.”

    Dual Protection Decisions and the Role of Family Planning and Public Health STD Services:

    - “Assuring dual protection involves both choosing a family planning method and making decisions about one's sexual behavior at the same time. “

    “To make these decisions, a person must know whether he or she personally is at risk for STIs and also how to protect against STIs.”

    - Providing the opportunity for an informed decision is a patient’s right and a provider’s responsibility. This includes:
    - Awareness of personal STD risks, and their consequences
    - Awareness of personal unintended pregnancy risk
    - Awareness of options for dual protection, and advantages and disadvantages
    - Accurate information about dual protection
    “Before clients decide on a method, however, providers should be sure to tell them that condoms are the only contraceptive method that protects against STIs.”

    - A patient’s understanding of their dual risk is key to an informed decision for effective protection. Understanding personal risk will shape a client’s decision.
    - A client’s relative risk should guide the provider’s recommendation
    Example: more than one partner, partner with more than one partner, multiple partners in sexual history, etc. indicates importance of condom use.

    Comparative risk of unprotected intercourse on unintended pregnancies and STI infections.*

    Unintended pregnancy/coital act PID per woman infected with cervical gonorrhea
    17%-30% mid-cycle
    <1% during menses
    40% if not treated
    0% if promptly and adequately treated
    Gonococcal transmission / coital act Tubal infertility per PID episode
    50% infected male, uninfected female
    25% infected female, uninfected male
    8% after first episode
    20% after second episode
    40% after three or more episodes

    *Cates W Jr. Reproductive tract infections. In: Hatcher RA, et al. Contraceptive Technology.
    17th ed. New York: Ardent Media, 1998:181.

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    URL: http://65.163.14.21/EIDP/dp.htm
     Last update: 03/05/08