Family planning providers can talk to clients about how they can protect themselves both from STIs, including HIV, and pregnancy (dual protection).

Choosing a Dual Protection Strategy

Every family planning client needs to think about preventing STIs, including HIV—even people who assume they face no risk. A provider can discuss what situations place a person at increased risk of STIs, including HIV (see Who Is At Risk?), and clients can think about whether these risky situations come up in their own lives. If so, they can consider 5 dual protection strategies.

One person might use different strategies in different situations; one couple might use different strategies at different times. The best strategy is the one that a person is able to practice effectively in the situation that she or he is facing. (Dual protection does not necessarily mean just using condoms along with another family planning method.)

Strategy 1: Use a male or female condom correctly with every act of sex.

  • One method helps protect against pregnancy and STIs, including HIV.
Strategy 2: Use condoms consistently and correctly plus another family planning method.

  • Adds extra protection from pregnancy in case a condom is not used or is used incorrectly.
  • May be a good choice for women who want to be sure to avoid pregnancy but cannot always count on their partners to use condoms.
Strategy 3: If both partners know they are not infected, use any family planning method to prevent pregnancy and stay in a mutually faithful relationship.

  • Many family planning clients will fall into this group and thus are protected from STIs, including HIV.
  • Depends on communication and trust between partners.
Other strategies, which do not involve using contraceptives, include:
Strategy 4: Engage only in safer sexual intimacy that avoids intercourse or otherwise prevents semen and vaginal fluids from coming in contact with each other’s genitals.

  • This strategy will not prevent syphilis, genital herpes, or infection with human papillomavirus. These spread through skin-to-skin contact.
  • Depends on communication, trust, and self-control.
  • If this is a person’s first-choice strategy, it is best to have condoms on hand in case the couple does have sex.
Strategy 5: Delay or avoid sexual activity (either avoiding sex any time that it might be risky or abstaining for a longer time).

  • If this is a person’s first-choice strategy, it is best to have condoms on hand in case the couple does have sex.
  • This strategy is always available in case a condom is not at hand.

People at high risk of HIV infection can take PrEP—pre-exposure prophylaxis. This daily treatment with oral antiretroviral drugs greatly reduces the chances of infection if exposed to HIV. PrEP can be a part of any dual protection strategy. PrEP can be used along with condoms and any other family planning method. Taking PrEP and a hormonal contraceptive at the same time does not reduce the effectiveness of either one.

Many clients will need help, support, and guidance to make their dual protection strategy succeed. For example, they may need help preparing to talk with their partners about STI protection, learning how to use condoms and other methods, and handling practical matters such as where to get supplies and where to keep them. If you can help with such matters, offer to help. If not, refer the client to someone who can provide more counseling or skills-building, such as role-playing to practice negotiating condom use.