Condom use at last sex by young men in Ethiopia: the effect of descriptive and injunctive norms

Abstract

BackgroundCondoms are an important prevention method in the transmission of HIV and sexually transmitted infections as well as unintended pregnancy. Individual-level factors associated with condom use include family support and connection, strong relationships with teachers and other students, discussions about sexuality with friends and peers, higher perceived economic status, and higher levels of education. Little, however, is known about the influence of social norms on condom use among young men in Ethiopia. This study examines the effect of descriptive and injunctive norms on condoms use at last sex using the theory of normative social behavior.MethodsA cross-sectional survey was implemented with 15-24 year old male youth in five Ethiopian regions in 2016. The analytic sample was limited to sexually active single young men (n = 260). Descriptive statistics, bivariate and multivariate logistic regressions were conducted. An interaction term was included in the multivariate model to assess whether injunctive norms moderate the relationship between descriptive norms and condom use.ResultsThe descriptive norm of knowing a friend who had ever used condoms significantly increased respondents’ likelihood of using condoms at last sex. The injunctive norm of being worried about what people would think if they learned that the respondent needed condoms significantly decreased their likelihood to use condoms. The injunctive norm did not moderate the relationship between descriptive norms and condom use. Young men who lived closer to a youth friendly service (YFS) site were significantly more likely to have used condoms at last sex compared to those who lived further away from a YFS site.ConclusionsSocial norms play an important role in decision-making to use condoms among single young men in Ethiopia. The interplay between injunctive and descriptive norms is less straightforward and likely varies by individual. Interventions need to focus on shifting community-level norms to be more accepting of sexually active, single young men’s use of condoms and need to be a part of a larger effort to delay sexual debut, decrease sexual violence, and increase gender equity in relationships.

Factors Associated with Knowledge of Transmission and Prevention of HIV/ AIDS among Men and Women in Uganda: Evidence from Demographic Health Survey of Uganda 2016

“…Previous studies have showed that education play a big role in curbing HIV/AIDS and this is consistent with this study as we found education statistically associated with HIV knowledge [14,34].Many studies showed that Early Antiretroviral Therapy (ART) and condom use can prevent transmission of HIV/ AIDS and this can lower the incidence of the infection hence controlling the spread of the disease [2][3][4][5]. Previous studies revealed that testing and counselling have shown a successful story since this helps in early case detection and early treatment which has played a major role in preventing mother to child transmission (MTCT) therefore this should continue to be scaled up as a public health strategy to prevent transmission of HIV/AIDS [10], [11].…”

“…Prevention of HIV-1 infection with Early Antiretroviral Therapy (ART), HIV pre and post exposure prophylaxis (PrEP) (PEP), condom use has been a successful story in sub-saharan Africa and throughout the continent. Antiretroviral therapy that reduces viral replication could limit the transmission of human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples [2][3][4][5][6][7]. Many studies has shown that sexuality education is key in prevention of HIV and related sexually transmitted diseases especially if given to adolescents, schools and many people those that receive sex education are likely not to indulge in risky sexual behaviours [8,9].…”

Determinants of condom use during last sexual intercourse among male college youth of Kaski, Nepal: A cross-sectional survey

“…Despite the Nepal government’s effort to make the condoms easily available and accessible, their use is low among male college youth. In countries such as Southern Brazil, China, Canada, United States, Ethiopia the prevalence of condom use in the last sexual intercourse among university students was 61.4%, 44.2%, 47.2%, 63.8%, and 55.8% respectively [ 24 – 28 ]. This difference might be due to the knowledge level about the condoms and youth’s attitude to use them within and outside the country.…”

Culture and Social Norms: Development and Application of a Model for Culturally Contextualized Communication Measurement (MC3M)

“…The conceptual definition of the key study constructs and the measures, including social norms, norm violations, individualism-collectivism, and tightness-looseness, were adapted from existing literature developed in the U.S and translated into each country's official language following the procedures outlined by Brislin (1986); validity and reliability evidence was provided. Likewise, Jain et al (2018) investigated the effect of descriptive and injunctive norms on condom use among young men in Ethiopia using norms measures from the TNSB (Rimal and Real, 2005) translated into Amharic, Afan Oromo, and Tigrigna. Adaptations were made in the norm measures to account for cultural context, but measurement validity and reliability evidence was not presented.…”