Determinants of Condom Use in Zambia: A Multilevel Analysis

Abstract

Research on the determinants of condom use in sub-Saharan Africa has focused on the personal characteristics of individuals and, more recently, on community characteristics such as levels of development and of contraceptive availability. Two additional community characteristics, however--the restraining influence exerted by social networks and traditional community institutions (both theorized to decline with population growth) and the degree of interpersonal communication concerning HIV/AIDS--should also be factored into research. This study uses data from the 2003 Zambia Sexual Behaviour Survey and other surveys to conduct multilevel analyses to assess the influence of each of these various characteristics on condom use in Zambia. The results show that condom use increases with interpersonal communication concerning HIV/ AIDS, community infrastructural development, and access to condoms, and decreases with population growth rate and density. The findings suggest that condom-promotion efforts should be attentive to community-level social norms, population trends, and informal social relationships and interpersonal communication.

Further evidence of community education effects on fertility in sub-Saharan Africa

“…In addition, it has been concluded in some recent studies from subSaharan Africa that, when women with the same level of education are compared, those who live in communities where others have relatively high education tend to have the lowest fertility (Kravdal 2002;DeRose and Kravdal 2007). Such associations that are indicative of externality effects of education have also been reported in fertility studies from other regions (Hirschman and Young 2000) and in investigations of fertility desires (Moursund and Kravdal 2003;Baschieri 2007) or contraceptive use (Benefo 2006(Benefo , 2010DeRose, Wu, and Dodoo 2010;McNay et al 2003;Moursund and Kravdal 2003;Stephenson et al 2007;Stephenson, Beke, and Tshibangu 2008) in various developing countries, with a variety of additional factors included (more or less appropriately) in the models. There are also studies, however, where associations have not shown up (Gupta and Mahy 2003;Yabiku 2006).…”

Spousal Communication and Contraceptive Use in Rural Nepal: An Event History Analysis

“…Previous research has documented the importance of interpersonal communication among siblings or peers in shaping fertility behavior (Kohler 1997; Kincaid 2000; Godley 2001; Kohler, Behrman, and Watkins 2001; Avogo and Agadjanian 2008; Benefo 2010). Some investigators have suggested that encouragement from social networks to use family planning may increase the likelihood of subsequent contraceptive use by stimulating spousal communication (Kincaid 2000; Avogo and Agadjanian 2008).…”

Condoms in sub-Saharan Africa

“…Self-and instrumental efficacy, beliefs that favour condom use, and supportive peer norms are positively correlated with condom use. 21,[52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67] Although it is widely acknowledged that the perception that one is susceptible to an STI such as HIV is necessary to motivate preventive action, perception of susceptibility to HIV infection has produced mixed and what appear to be contradictory, influences on condom use. 24,63,[66][67][68] Difficulties in establishing time ordering in the predominantly cross-sectional samples and acknowledgement that perceptions of susceptibility and condom use form a reciprocal relationship of influence have been used to explain these contradictions.…”