ABSTRACT
Background: In Ethiopia 16.2of births are not wanted; 18.7of births are mistimed; and 90of adult cases of HIV are attributable to heterosexual activity. Dual protection is an important public health intervention in this context. Objective: To assess the extent and predictors of dual protection among married or cohabiting people in Northern Methodology: A community-based stratified cross-sectional survey of 868 married or cohabiting women and men; and four focus group discussions; were conducted in Adwa town; northern Ethiopia; in 2006. Results: 13.8of respondents practiced effective dual protection. Predictors included male sex; being literate; being employed; approval of condom use within marriage; and discussion of dual protection. Focus group participants emphasized the negative community perceptions associated with condom use within marriage. Conclusion: Use of dual protection was unusual in this North Ethiopian town. Condom use was uncommon among current hormonal contraceptive users; and condom use within marriage was highly stigmatized