Introduction
South Africa is one of the countries hardest hit by HIV/AIDS. Of particular concern, new
infections among young people, especially young women and girls are on the rise. Despite
widespread awareness and prevention campaigns, the prevalence of HIV and deaths caused
by AIDS are still on the increase, whereas condom use particularly in rural areas remains
low. Consistent condom use is central to the prevention of unwanted pregnancies, HIV and
other STIs, yet young men and women alike are hesitant to use condoms because of threats to
their relationships, cultural roles and at times economic survival.
Purpose
The purpose of this study is to identify socio-cultural and behavioral factors that influence
condom use among youths in Limpopo province, South Africa. This adds to a growing body
of knowledge on the determinants of condom use and how they might shape effective HIV
prevention programs.
Objectives
1. To conduct a secondary data analysis that examines the determinants of condom use, for
men and women separately in relation to the following factors:
Socio-demographic characteristics- age, education, marital status, migration and iv
socio-economic status
Sexual behavior characteristics- partnership type (spousal, non spousal, or both), age
at sexual debut, number of lifetime sexual partners, contraceptive use (females only)
and HIV-status
Socio-cultural characteristics - perceived risk of HIV infection, condom self efficacy
(males only), partner communication on sex, condoms, HIV and other STI’s, beliefs
on gender norms, attitudes towards gender violence, knowledge on HIV/AIDS and
HIV/AIDS related stigma
To compare the results of this analysis to other national studies on condom use among
young people.
To use the results of this analysis to make recommendations to improve HIV control in
rural South Africa.Methods
This study is a secondary analysis of data collected from a sample of 2236 sexually active
young people aged between 14-35 years in Limpopo province, South Africa. The data used in
this study is part of a wider public health intervention, the Intervention with Micro-finance
for AIDS and Gender Equity (IMAGE) study. STATA 8.0 was used to analyze data in
bivariate and multivariate analyses to assess determinants of consistent condom use and
condom use at last sex for males and females separately as the patterns of associations are
likely to differ between them.
Results
Overall condom use in this population was low: less than a quarter of respondents used
condoms consistently and less than one third of men and women used condoms at last sex.
This is especially true of females, married couples and those who have multiple partners. In
multivariate analysis, significant predictors of consistent condom use for both sexes included
good communication, older age at sexual debut, low risk perception of HIV infection,
progressive attitudes towards gender violence and high HIV-related stigma. High condom
self-efficacy, defined as the intention to pick up or purchase condoms with the intention of
use, was the most powerful predictor of both condom use indices among males. Among
females only, having fewer than three lifetime sexual partners was positively associated with using condoms consistently. Lastly, females who used condoms as their main method of
contraception were up to 20 times more likely to use them consistently and at last sex.
Conclusions
HIV prevention programmes in this population should focus on delaying sexual debut,
increasing perceived risk of HIV infection, encouraging partner communication, making
condoms more easily accessible to young men and addressing gender inequalities.
Furthermore, the dual protection offered by condoms against unwanted pregnancies and
against HIV and other STI’s should be emphasized in this population as it plays an important
role in the prevention of HIV.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/5057 |
| Date | 15 July 2008 |
| Creators | Chandiwana, Nomathemba Chiwoneso |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 2279747 bytes, 124098 bytes, application/pdf, application/pdf, application/pdf, application/pdf |
Page generated in 0.0021 seconds