Correlates of consistent condom use among recently initiated and traditionally circumcised men in the rural areas of the Eastern Cape Province, South Africa

Abstract

BackgroundConsistent use of condoms is the most effective method of preventing STIs including HIV. However, recent evidence suggests that limited knowledge about HIV prevention benefits from male circumcision leads to inconsistent condom use among traditionally circumcised men. The aim of this paper is to report on the prevalence of consistent condom use and identify its psychosocial correlates to inform future HIV prevention strategies among traditionally circumcised men in rural areas of the Eastern Cape Province of South Africa.MethodsA cross-sectional study using interviewer administered fully structured questionnaires was conducted among 1656 men who had undergone initiation and traditional male circumcision in rural areas of the Eastern Cape Province of South Africa. Logistic regression was used to evaluate univariate and multivariate relationships of psychosocial correlates with consistent condom use.ResultsThe mean age of the participants was 21.4 years. About 45% belonged to the amaXhosa ethnic group, followed by 15.1% of the amaMpondo, 11.6% of the amaHlubi, and 27.9% from other ethnic groups. A total of 72.3% reported having a main sexual partner and of those 44.8% indicated having other sexual partners as well. About 49% reported consistent condom use and 80% used free government issued condoms, varies among ethnic groups. A total of 35.1% indicated having tested for HIV. Of those who tested for HIV, 46% reported inconsistent condom use when having sex with their sexual partners. Univariate and multivariate analyses showed a positive association between consistent condom use and the general knowledge of condom use, attitude towards condom use with main and casual sexual partners, subjective norm towards condom use with the main sexual partner, perceived self-efficacy towards condom use, positive self-esteem, beliefs about traditional male circumcision and STI protection, attitude towards gender based violence, and cultural alienation.ConclusionsThe study findings reveal important target points for future cultural sensitive health education aimed at increasing consistent condom use among initiated and traditionally circumcised men in the Eastern Cape Province.

Factors associated with non-use of condoms in an online community of frequent travellers

“…With an alpha of 0.05 and assuming 80% power, a sample size of 250 was shown to be required to detect an association strength of 2.04 [12] or higher, given the proportion of 41.7% of affected individuals who were not exposed and 52.9% who were exposed.…”

“…Most studies tend to extend their definition of condom use, for example, a study conducted in South Africa used a score consisting of three items: "always", "sometimes" and "never" [12]. However, given that the World Health Organisation (WHO) has reported that condoms must be used during 100% of sexual activity to effectively prevent STIs, for the purposes of the current study, inconsistent condom use was defined as condom use at a frequency less than 100% during sexual activity [4].…”

HIV risk perception and consistency in condom use among adolescents and young adults in urban Cape Town, South Africa: a cumulative risk analysis

“…13,16 Using condoms also provides a safe family planning option that has no known side effects, thus providing dual protection against unwanted pregnancies and STIs. Globally, condom programs are recommended as highly effective in preventing HIV transmission, adolescence pregnancy, and are generally regarded as acceptable to young people.…”

Understanding the Psychosocial Correlates of the Intention to Use Condoms among Young Men in KwaZulu-Natal, South Africa

“…In South Africa, more specifically, a few studies have used the Theory of Planned Behaviour as a framework to research gender power imbalances in the intention to use condoms [33], the role of individual and group factors in intentions to use condoms [34], adolescent condom use behaviour [25,35,36], the influence intention has on behaviour among university students [37], and condom use motivation in traditional male circumcision initiates [38]. These studies also vary in their prediction of the most influential cognitive constructs, and some also show a clear gender difference in their predictability where both sexes were sampled.…”

“…Young men between the ages of 18 and 35 are particularly at a high risk of HIV infection. Given the gender imbalances in HIV transmission, it is expected that developing culturally sensitive interventions targeting young men will help increase safer sexual practices [38]. A focus on young men can also help impact the gender imbalances reported by some studies that, in heterosexual relationships, women do not use condoms mainly because of their sexual partner’s refusal to use them [10,11].…”