“I enjoy sex more without condoms": revisiting barriers and facilitators of consistent condom use among adolescents and young adults in South Africa

Abstract Background Previous studies have examined consistent condom use correlates in South Africa, focusing on sociodemographic factors, HIV risk perceptions, relationship conflict, multiple sexual partners, and masculinity. However, the effect of family financial support, HIV testing, partner communication and self-efficacy for HIV prevention is less studied. We drew from a cross-sectional survey to address this gap and highlight the key barriers and facilitators of consistent condom use among young people. Methods We analysed data obtained from 631 unmarried sexually active male and females students selected using stratified sampling from a university in Eastern Cape Province of South Africa. Consistent condom use was defined as regular use of condoms in all sexual encounters in the past year. We used an open-ended question to probe the reasons for inconsistent condom use. Adjusted and unadjusted regression analysis were fitted to examine factors associated with consistent condom use. Results The prevalence of consistent condom use was 39.3% (CI: 35.5%-43.2%), with no significant gender and age differences. After adjusting for relevant covariates, living with foster parents (AOR; 1.80 95% CI; 1.09-2.97), adequate family financial support (AOR; 2.49 95% CI; 1.71-3.62), partner knew status (AOR; 1.91 95% CI; 1.09-3.37) and feeling confident in one's ability to prevent HIV (AOR; 1.77 95% CI; 1.09-2.86) were associated with increased odds of consistent condom use. However, self-report of low condom self-efficacy (AOR; 0.58 95% CI; 0.40-0.85) and alcohol use (AOR; 0.83 95% CI; 0.58-1.19) were associated with lower odds of consistent condom use. Young people who inconsistently used condoms reiterated that sex is often unplanned and condoms are not always available. The desire for maximum pleasure, partner's objection, trust, and use of hormonal contraceptives were further reasons others inconsistently use condoms. Conclusions Inconsistent condom use remains a challenge among unmarried sexually active young people in South Africa. Education of young people on the need for partner communication about HIV, HIV testing uptake, and condom use should happen more rigorously in school and through the media to improve their consistent use of condoms.

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“I enjoy sex more without condoms": revisiting barriers and facilitators of consistent condom use among adolescents and young adults in South Africa

10.21203/rs.3.rs-271620/v1 ◽

2021 ◽

Author(s):

Anthony Idowu Ajayi ◽

Olumuyiwa Omonaiye ◽

Charlotte Nwogwugwu

Keyword(s):

South Africa ◽

Young People ◽

Condom Use ◽

Financial Support ◽

Consistent Condom ◽

Sexually Active ◽

Partner Communication ◽

Consistent Condom Use ◽

Inconsistent Condom ◽

Inconsistent Condom Use

Abstract Background Previous studies have examined consistent condom use correlates in South Africa, focusing on sociodemographic factors, HIV risk perceptions, relationship conflict, multiple sexual partners, and masculinity. However, the effect of family financial support, HIV testing, partner communication and self-efficacy for HIV prevention is less studied. We drew from a cross-sectional survey to address this gap and highlight the key barriers and facilitators of consistent condom use among young people. Methods We analysed data obtained from 631 unmarried sexually active male and females students selected using stratified sampling from a university in Eastern Cape Province of South Africa. Consistent condom use was defined as regular use of condoms in all sexual encounters in the past year. We used an open-ended question to probe the reasons for inconsistent condom use. Adjusted and unadjusted regression analysis were fitted to examine factors associated with consistent condom use. Results The prevalence of consistent condom use was 39.3% (CI: 35.5%-43.2%), with no significant gender and age differences. After adjusting for relevant covariates, living with foster parents (AOR; 1.80 95% CI; 1.09-2.97), adequate family financial support (AOR; 2.49 95% CI; 1.71-3.62), partner knew status (AOR; 1.91 95% CI; 1.09-3.37) and feeling confident in one's ability to prevent HIV (AOR; 1.77 95% CI; 1.09-2.86) were associated with increased odds of consistent condom use. However, self-report of low condom self-efficacy (AOR; 0.58 95% CI; 0.40-0.85) and alcohol use (AOR; 0.83 95% CI; 0.58-1.19) were associated with lower odds of consistent condom use. Young people who inconsistently used condoms reiterated that sex is often unplanned and condoms are not always available. The desire for maximum pleasure, partner's objection, trust, and use of hormonal contraceptives were further reasons others inconsistently use condoms.Conclusions Inconsistent condom use remains a challenge among unmarried sexually active young people in South Africa. Education of young people on the need for partner communication about HIV, HIV testing uptake, and condom use should happen more rigorously in school and through the media to improve their consistent use of condoms.

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Inconsistent Condom Use among Public Primary Care Patients with Tuberculosis in South Africa

The Scientific World JOURNAL ◽

10.1100/2012/501807 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Gladys Matseke ◽

Karl Peltzer ◽

Julia Louw ◽

Pamela Naidoo ◽

Gugu Mchunu ◽

...

Keyword(s):

South Africa ◽

Primary Care ◽

Condom Use ◽

Multivariable Analysis ◽

High Rate ◽

Consistent Condom ◽

Consistent Condom Use ◽

Inconsistent Condom ◽

The Past ◽

Inconsistent Condom Use

The high rate of HIV infections among tuberculosis (TB) patients in South Africa calls for urgent HIV reduction interventions in this subpopulation. While correct and consistent condom use is one of the effective means of HIV prevention among sexually active people, there is insufficient research on condom use among TB patients in South Africa. The aim of this paper was to determine the prevalence of inconsistent condom use among public primary care TB patients and its associated factors using a sample of 4900 TB patients from a cross-sectional survey in three health districts in South Africa. Results indicated that when asked about their consistency of condom use in the past 3 months, 63.5% of the participants reported that they did not always use condoms. In the multivariable analysis, being married (OR=1.66; 95% CI 1.25–2.20) or cohabitating or separated, divorced, or widowed (OR=3.67; 1.85–7.29), lower educational level (OR=0.66; 0.46–0.94), greater poverty (OR=1.60; 1.25–2.20), not having HIV status disclosed (OR=0.34; 0.25–0.48), sexual partner on antiretroviral treatment (OR=0.38; 0.23–0.60), and partner alcohol use before sex (OR=1.56; 1.30–1.90) were significantly associated with inconsistent condom use in the past 3 months. The low proportion of consistent condom use among TB patients needs to be improved.

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Sexual And Reproductive Health Needs Of Street-Involved Young People: Findings From A Baseline Survey In Southwest Nigeria

10.21203/rs.2.23753/v1 ◽

2020 ◽

Author(s):

Atinuke O Olaleye ◽

Mary O. Obiyan ◽

Morenike O. Folayan

Keyword(s):

Young People ◽

Reproductive Health ◽

Condom Use ◽

Sexual And Reproductive Health ◽

Sexually Active ◽

Inconsistent Condom ◽

Targeted Interventions ◽

Modern Contraception ◽

Inconsistent Condom Use ◽

Age And Sex

Abstract Background To achieve the Sustainable Development Goal 3, street-involved young people (SIYP) require consideration in the strategies for ensuring universal access to sexual and reproductive healthcare. This study aims to determine the age- and sex-specific sexual and reproductive health (SRH) needs of SIYP in Nigeria. Methods This was a cross-sectional study that recruited 1,505 SIYP aged 10-24 years using respondent-driven and time-location sampling. Data were collected on socioeconomic characteristics, access to SRH information, contraceptive knowledge and use, sexual behavior and sexual practice using interviewer-administered questionnaires. The outcome variables were inconsistent condom use, multiple sexual partners and transactional sex. Binomial regression analysis models were developed to determine risk indicators for outcome variables. Results Though 968 (64.3%) participants were sexually active and 1,089 (72.4%) knew about modern contraception, only 300 (31.0%) sexually active respondents use modern contraceptives. Knowledge of modern contraception (AOR: 0.11; 95% C.I: 0.01-0.82, p=0.03) and being employed (AOR: 0.38; 95% C.I: 0.15-0.95, p=0.04) reduced the odds for inconsistent condom use among male SIYPs. For the female SIYPs, knowledge of modern contraception reduced the odds for inconsistent condom use (AOR: 0.26; 95% C.I: 0.08-0.90, p=0.03), while having access to SRH information significantly increased the odds for inconsistent condom use (AOR: 5.06; 95% C.I: 1.67-15.37, p=0.004). Conclusion There are age- and sex- related differences in the factors associated with risky sexual behaviors among SIYP. Addressing these differences in the delivery of targeted interventions to reduce sexual health risk of SIYP may be required.

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Prevalence and factors influencing consistent condom use among sexually active young people attending a youth friendly centre in Kenya, 2008

East African Journal of Public Health ◽

10.4314/eajph.v7i4.64747 ◽

2011 ◽

Vol 7 (4) ◽

Author(s):

AS Anyangu

Keyword(s):

Young People ◽

Condom Use ◽

Consistent Condom ◽

Sexually Active ◽

Consistent Condom Use ◽

Factors Influencing ◽

Youth Friendly

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Factors associated with sexual and reproductive health behaviour of street-involved young people: findings from a baseline survey in southwest Nigeria

10.21203/rs.2.23753/v2 ◽

2020 ◽

Author(s):

Atinuke O Olaleye ◽

Mary O. Obiyan ◽

Morenike O. Folayan

Keyword(s):

Young People ◽

Condom Use ◽

Sexual And Reproductive Health ◽

Sexually Active ◽

Inconsistent Condom ◽

Factors Associated ◽

Modern Contraception ◽

Southwest Nigeria ◽

Inconsistent Condom Use ◽

Age And Sex

Abstract Background: To achieve the Sustainable Development Goal 3, which is to ensure healthy lives and promote well-being for all persons of all ages, street-involved young people (SIYP) must be assured of universal access to sexual and reproductive healthcare. This study aims to determine the factors associated with age- and sex-specific differences in the sexual and reproductive health (SRH) behaviour of SIYP in southwest Nigeria.Methods: This was a cross-sectional study that recruited 1505 SIYP aged 10-24 years by use of respondent-driven and time-location sampling. Data were collected through interviewer-administered questionnaires on socioeconomic characteristics; access to SRH information; contraceptive knowledge and use; sexual behavior; and sexual practice. The outcome variables were inconsistent condom use, multiple sexual partners, and transactional sex. Binomial regression analysis models were developed to determine risk indicators for outcome variables. Results: Although 968 (64.3%) participants were sexually active and 1089 (72.4%) knew about modern contraception, only 300 (31.0%) sexually active respondents used modern contraceptives. Knowledge of modern contraception (AOR: 0.11; 95% C.I: 0.01-0.82, p=0.03) and being employed (AOR: 0.38; 95% C.I: 0.15-0.95, p=0.04) reduced the odds for inconsistent condom use among male SIYPs. For female SIYPs, knowledge of modern contraception reduced the odds for inconsistent condom use (AOR: 0.26; 95% C.I: 0.08-0.90, p=0.03), whereas access to SRH information significantly increased the odds for inconsistent condom use (AOR: 5.06; 95% C.I: 1.67-15.37, p=0.004). Conclusion: Age- and sex- related factors associated with risky sexual behaviors vary among SIYP. Addressing these differences in the delivery of targeted interventions to reduce sexual health risk of SIYP may be required.

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Psychosocial Risk Factors for Inconsistent Condom Use in Young People with First Episode Psychosis

Community Mental Health Journal ◽

10.1007/s10597-011-9370-4 ◽

2011 ◽

Vol 47 (6) ◽

pp. 679-687 ◽

Cited By ~ 4

Author(s):

Adrienne P. Brown ◽

Dan I. Lubman ◽

Susan J. Paxton

Keyword(s):

Risk Factors ◽

Young People ◽

Condom Use ◽

First Episode Psychosis ◽

Psychosocial Risk Factors ◽

Psychosocial Risk ◽

First Episode ◽

Inconsistent Condom ◽

Episode Psychosis ◽

Inconsistent Condom Use

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Correlates of HIV Infection Among Sexually Active Adults in Kenya: A National Population-Based Survey

The Open AIDS Journal ◽

10.2174/1874613601105010125 ◽

2011 ◽

Vol 5 (1) ◽

pp. 125-134 ◽

Cited By ~ 17

Author(s):

Tom Oluoch ◽

Ibrahim Mohammed ◽

Rebecca Bunnell ◽

Reinhard Kaiser ◽

Andrea A Kim ◽

...

Keyword(s):

Hiv Infection ◽

Condom Use ◽

Population Based ◽

Consistent Condom ◽

Sexually Active ◽

Sex Partners ◽

Consistent Condom Use ◽

Nationally Representative ◽

Active Adults ◽

Sex Partner

Objective: To identify factors associated with prevalent HIV in a national HIV survey in Kenya. Methods: The Kenya AIDS Indicator Survey was a nationally representative population-based sero-survey that examined demographic and behavioral factors and serologic testing for HIV, HSV-2 and syphilis in adults aged 15-64 years. We analyzed questionnaire and blood testing data to identify significant correlates of HIV infection among sexually active adults. Results: Of 10,957 eligible women and 8,883 men, we interviewed 10,239 (93%) women and 7,731 (87%) men. We collected blood specimens from 9,049 women and 6,804 men of which 6,447 women and 5,112 men were sexually active during the 12 months prior to the survey. HIV prevalence among sexually active adults was 7.4%. Factors independently associated with HIV among women were region (Nyanza vs Nairobi: adjusted OR [AOR] 1.6, 95%CI 1.1-2.3), number of lifetime sex partners (6-9 vs 0-1 partners: AOR 3.0, 95%CI 1.6-5.9), HSV-2 (AOR 6.5, 95%CI 4.9-8.8), marital status (widowed vs never married: AOR 2.7, 95%CI 1.5-4.8) and consistent condom use with last sex partner (AOR 2.3, 95%CI 1.6-3.4). Among men, correlates of HIV infection were 30-to-39-year-old age group (AOR 5.2, 95%CI 2.6-10.5), number of lifetime sex partners (10+ vs 0-1 partners, AOR 3.5, 95%CI 1.4-9.0), HSV-2 (AOR 4.7, 95%CI 3.2-6.8), syphilis (AOR 2.4, 95%CI 1.4-4.0), consistent condom use with last sex partner (AOR 2.1, 95% CI 1.5-3.1) and lack of circumcision (AOR 4.0, 95%CI 2.8 - 5.5). Conclusion: Kenya’s heterogeneous epidemic will require regional and gender-specific prevention approaches.

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South Africa: Providers should encourage sexually active youth to use condoms

10.31899/rh2001.1028 ◽

2001 ◽

Author(s):

Keyword(s):

South Africa ◽

Young People ◽

Reproductive Health ◽

Condom Use ◽

Service Providers ◽

Sexual Practices ◽

Sexually Active ◽

Kwazulu Natal ◽

Youth Centers ◽

Hiv Aids

To assess the effectiveness of youth centers in reaching adolescents with reproductive health information, life skills, and services, the Reproductive Health Research Unit in KwaZulu Natal and the Population Council conducted an assessment of 12 youth centers and their affiliated peer education programs. The centers were run by the KwaZulu Natal Department of Health, the loveLife program, and the Youth and Adolescent Reproductive Health Program. Researchers also examined young people’s use of condoms as protection against pregnancy and HIV/AIDS. Data sources for this study, conducted in 2000, were an inventory of youth center services, interviews with center staff and clients, service statistics, and community surveys of 1,399 young people aged 12–24 and their parents. As noted in this brief, the study found that many sexually active young people in South Africa are knowledgeable about the sexual transmission of HIV/AIDS but do not use condoms consistently. Service providers can do more to promote condom use among youth by placing condom dispensers in private places and counseling youth on correct condom use and safer sexual practices.

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Inconsistent condom use between serodifferent sexual partnerships to the human immunodeficiency virus

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.3059.3222 ◽

2019 ◽

Vol 27 ◽

Cited By ~ 1

Author(s):

Renata Karina Reis ◽

Elizabete Santos Melo ◽

Nilo Martinez Fernandes ◽

Marcela Antonini ◽

Lis Aparecida de Souza Neves ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Condom Use ◽

Consistent Condom ◽

Bivariate Analysis ◽

Treatment As Prevention ◽

Sexual Partnership ◽

Inconsistent Condom ◽

Cross Sectional ◽

Immunodeficiency Virus ◽

Inconsistent Condom Use

Objective: to analyze predictors of inconsistent condom use among HIV-positive people with sexual immunodeficiency virus serodifferent sexual partnership. Method: cross-sectional, analytical study with a consecutive non-probabilistic sample consisting of people living with the human immunodeficiency virus with serodifferent sexual partnership and who were in outpatient clinical follow-up. Data were collected through individual interviews guided by a semi-structured questionnaire and subsequently analyzed with bivariate analysis and logistic regression. Results: Seven variables were independently associated with inconsistent condom use. Schooling less than 11 years of schooling (4.9 [2.4-10.1]), having multiple partnerships (5.0 [1.3-19.6]), using alcohol (2.1 [1.1 -4.4]) or other drugs (2.8 [1.2-6.3]), do not receive advice from a healthcare professional (2.0 [1.1-3.9]), have no knowledge of treatment as prevention (3.0 [1,2-6,9]) and not knowing that undetectable viral load reduces the risk of human immunodeficiency virus transmission (3.8 [1,1-13,7]) were predictors for inconsistent condom use. Conclusion: The study showed that psychosocial factors interfere with consistent condom use between serodifferent partnerships. Thus, it is highlighted that there is a need for comprehensive interventions that include the integration of clinical and psychosocial care.

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