Dimensions of poverty and inconsistent condom use among youth in urban Kenya

Abstract

To date, research on the link between poverty and unsafe sexual behaviors has utilized limited measures of socioeconomic status and has overlooked key dimensions of poverty at the individual level. This study explored how various dimensions of socioeconomic status are associated with inconsistent condom use and how these associations vary by gender. We analyzed unique life history survey data from 261 young men and women in Kisumu, Kenya, and conducted analyses based on 959 person-months in which respondents had been sexually active in nonmarital relationships. Dependent variables were inconsistent condom use (not always using a condom) and never use of condoms. Condoms were used inconsistently in 57% of months and were never used in 31%. Corroborating existing literature, lower household wealth and lower educational attainment were associated with inconsistent condom use. Lower individual economic status (lower earned income, food insufficiency, and larger material transfers from partners) were also important determinants of inconsistent condom use. There were no significant differences in these associations by gender, with the exception of food insufficiency, which increased the risk of inconsistent condom use for young women but not for young men. None of these individual measures of socioeconomic status were associated with never use of a condom. The findings suggest that both household- and individual-level measures of socioeconomic status are important correlates of condom use and that individual economic resources play a crucial role in negotiations over the highest level of usage. The results highlight the importance of poverty in shaping sexual behavior, and, in particular, that increasing individual access to resources beyond the household, including ensuring access to food and providing educational and work opportunities, could prove to be effective strategies for decreasing the risk of HIV among youth.

Does Mass-Media Public Communication Campaign Normalize Discussion, Attitude and Behavior about Condom Use among Married Men in India?

“…The similar finding was validated by Cohen et al in his study, attributing cost as a barrier to condom use [40]. In addition, a study among youth in urban Kenya suggests that both household and individual level measures of socioeconomic status are important correlates of condom use and that individual economic resources plays a crucial role in negotiations over the highest level of usage [41]. Similarly, in other studies of female sex workers and truckers, it shows that the poor financial status is inversely associated with consistent condom use [42,43].…”

Factors associated with unprotected sexual practice among men and women with mental illnesses in Brazil

“…Lower family income was associated with unprotected sex among men only. Other studies have also found an association between low socio-economic status and inconsistent condom use 20,21 . In a qualitative study with men without psychiatric disorders, one of the reasons for not using condoms was attributed to the high cost of this input 22 .…”

“…In a qualitative study with men without psychiatric disorders, one of the reasons for not using condoms was attributed to the high cost of this input 22 . Moreover, these findings suggest that men with low income may have the least information about forms of HIV transmission and low decision-making power within their relationships to practice safe sex 20,21 . On the other hand, older age (> 40 years old) was associated with higher odds of unprotected sex among women only.…”

Coping and the biosocial consequences of food insecurity in the 21st century

“…Dunkle et al (2007) working with a sample of 3,982 nonpregnant women in Soweto South Africa showed that those women who had experienced hunger, measured by a single question, in their households had 1.6 greater odds of reporting transactional sex with a nonprimary partner, and that transactional sex was associated with HIV infection in multivariate models. Davidoff-Gore et al (2011) also showed that among 261 Kenyan youth aged 18-24 years, food insufficiency, measured by a single question, was one of the few variables that was associated with inconsistent condom use, a risk factor for HIV and other STIs. This effect was strongest among food insufficient females who had five times greater odds of inconsistent condom use when compared with food sufficient females.…”