WHO guidelines recommend dual contraceptive method use. They suggest using condoms and another contraceptive to reduce both incidences of HIV/sexually transmitted infection transmission and unintended pregnancies. Researchers did this qualitative study to assess the barriers to and motivations for dual contraceptive use in Kenyan HIV-serodiscordant couples.
The authors conducted qualitative semistructured interviews using a semistructured questionnaire. The researchers included twelve male and twelve female serodiscordant couples and ten women with incident pregnancies during the cohort studies.
Participants said that perceptions of side effects, male partner preference, and reproductive desire were critical factors in contraceptive decisions. Both men and women saw dual contraceptive method use as redundant and a sign of possible unfaithfulness. Many participants actively desired pregnancy, but few were able to define monthly fertility windows accurately.
The study concluded that dual contraceptive method use was low in these HIV-serodiscordant couples. The reasons for low use included finding it unnecessary while using condoms and others being more focused on conceiving a child. More acceptable strategies include biomedical HIV prevention, including male circumcision, pre-exposure prophylaxis, or antiretroviral therapy to reduce HIV transmission, to promote safer sexual relations with HIV-serodiscordant couples, and safer conception when desired.
Reference: https://srh.bmj.com/content/42/4/264
