Factors associated with condom use among men and women living with HIV in Lilongwe, Malawi: a cross-sectional study

Haddad, Lisa; Tang, Jennifer H.; Krashin, Jamie W.; Ng’ambi, Wingston; Tweya, Hannock; Samala, Bernadette; Chiwoko, Jane; Chaweza, Thom; Hosseinipour, Mina C.; Lathrop, Eva; Jamieson, Denise J.; Phiri, Sam

doi:10.1136/bmjsrh-2017-101825

Cited by 18 publications

(24 citation statements)

References 16 publications

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“…Although women who used condoms during last vaginal intercourse cited HIV prevention as their main reason for condom use, the decreased rate of consistent condom use during the previous six-month period demonstrates that other factors influenced their actual practices over multiple sexual episodes. This is also supported by the trend toward reduced condom use in women who reported greater sexual frequency, which has been seen in other studies [10, 23].…”

Section: Discussionsupporting

confidence: 83%

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Factors associated with condom use among HIV-positive women living in Atlanta, Georgia

et al. 2019

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ObjectivesConsistent condom use is essential to reducing heterosexual transmission of HIV. African Americans are disproportionately affected by HIV in the United States despite comprising a small percentage of the population. Our objectives were to evaluate factors associated with self-reported condom use in a cohort of predominantly African American women receiving HIV care in Atlanta, Georgia.MethodsA cross-sectional study of reproductive knowledge, attitudes, and practices among adult, sexually-active, HIV-positive women attending the Grady Infectious Disease Clinic in Atlanta, Georgia was conducted from July, 2013 to November, 2014 to evaluate factors associated with self-reported condom use. Primary outcomes included: condom use at last vaginal intercourse and consistent condom use with vaginal intercourse over the last six months. Descriptive, bivariable, and multivariable logistic regression analyses were performed.ResultsOf 187 women enrolled, 170 reported having vaginal intercourse in the last six months. Seventy-four percent used condoms at last vaginal intercourse, whereas 53% reported consistent condom use over the last six months. In adjusted analyses, factors associated with condom use at last intercourse included decreased frequency of sex, no history of drug use, and confidence to discuss condom use with sexual partners (p<0.05). Factors associated with consistent condom use in the past six months were older age, being single/dating, and confidence to discuss condom use with sexual partners. History of drug use, having HIV-positive partners, and unprotected anal intercourse were associated with inconsistent use (p<0.05).ConclusionsImproved strategies are needed to educate women on the importance of safe sexual practices and condom negotiation. Healthcare providers should strive to have an open dialogue with patients about condom use, whether they engage in anal sex, and its risks.

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Section: Discussionsupporting

confidence: 83%

“…Many of the previous studies that have examined condom use practices in HIV-positive adult women were done in sub-Saharan Africa where HIV rates are much higher compared to the U.S. [8–10]. However, these populations may not be generalizable due to socio-economic, cultural, and religious differences.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with condom use among HIV-positive women living in Atlanta, Georgia

et al. 2019

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“…This is crucial, noting that, as the war against the HIV epidemic advances globally, massive gain will largely depend on everyone taking responsibility being accountable to their sexual behaviors. This finding is consistent with a recent study in Mozambique which found that knowledge of HIV–positive status (a proxy for testing) is associated with more frequent condom use,30 and several others,31,32 thus corroborating the known positive correlation between health knowledge and health practice 33. It is also argued that knowledge is imperative for social transformation and has been considered as a key factor in enhancing decision-making among individuals 34…”

Section: Discussionsupporting

confidence: 91%

<p>Understanding The Combined Effects Of The Knowledge Of HIV/AIDS Prevention Methods On Condom Use: A Case Of Njombe And Tanga Regions Of Mainland Tanzania</p>

Aloni¹,

Mbago²,

Sichona³

2019

HIV

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AimThis study assesses how the combined effects of knowledge of the HIV/AIDS prevention methods (ie, abstinence (A), being faithful (B), condom use (C), and diagnosis or testing (D)) influence behavioral change in terms of condom use.MethodsThe study employed a cross-sectional design. Data were collected using a household survey conducted in 2017 in the Tanga and Njombe Regions of Tanzania through a structured questionnaire. The dependent variable was condom use during the last sexual intercourse. The main independent variable was knowledge of HIV prevention methods, referred to in this study as “knowledge of ABCD of HIV/AIDS prevention”. A respondent with knowledge of three or more of the ABCD was classified as having good knowledge of HIV prevention. Those with knowledge of two, one, or none of the ABCD were classified as having average, fair, and poor knowledge of HIV prevention methods, respectively. Data analysis included univariate analysis, bivariate analysis, and multivariate logistic regression analysis. The study included 660 respondents aged 15–64 years.ResultsThe study indicates that the majority (52.2%) of the respondents had average knowledge of the HIV prevention methods. That is, they were knowledgeable of any two of the A, B, C, and D of HIV prevention methods. Condom use during the last sexual intercourse was reported by 46.5% of respondents. Multivariate analysis showed that condom use was 1.48-times more likely among respondents with good knowledge of ABCD of HIV/AIDS prevention than those with poor knowledge.ConclusionThe predictive effect of knowledge of the HIV prevention methods on condom use was more visible when assessed in combination than when treated at A, B, C, and D in isolation. This suggests that successful behavioral change towards HIV/AIDS aversion requires dedicated efforts that promote comprehensive knowledge of all the methods through which the epidemic can be transmitted.

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“…However, unlike condoms, these methods are unable to prevent sexually-transmitted infections [28]. Even when women desire consistent condom use, gender power imbalances may affect their ability to negotiate with their partners [31–33]. The practical and socio-cultural challenges of condom use (whether alone or as dual protection) among HIV-affected couples need to be further explored, with the development of counter-strategies in mind.…”

Section: Discussionmentioning

confidence: 99%

Correlates of reported modern contraceptive use among postpartum HIV-positive women in rural Nigeria: an analysis from the MoMent prospective cohort study

et al. 2019

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BackgroundNigeria has an annual population of ~ 200,000 women who are both pregnant and HIV-positive. High unmet need for family planning in this population could lead to unintended pregnancies, along with the increased risk of mother-to-child transmission of HIV (MTCT). To identify modifiable barriers and facilitators in effective family planning, we examined correlates of modern contraceptive use among HIV-positive women enrolled in the MoMent prevention of MTCT (PMTCT) implementation research study in rural North-Central Nigeria.MethodsIn this prospective cohort study, HIV-positive pregnant women were enrolled at 20 Primary Healthcare Centers and followed up to 12 months postpartum. Baseline socio-demographic, clinical and obstetric data were collected at enrollment. Participants were to receive routine family planning counselling from healthcare workers during postnatal visits. Analysis utilized baseline data linked to available family planning information collected from each woman at the first postpartum visit. Multivariate logistic regression was performed to determine factors associated with modern contraceptive use.ResultsOut of 497 women enrolled, family planning data was available for 399 (80.3%) women, of whom 349 (87.5%) received family planning counselling, and 321 (80.5%) were 30 years old or less. Two-thirds (268, 67.2%) of the cohort analyzed had 1–2 children at baseline; 24.8% (n = 99) had 3–4 children, and 8.0% (n = 32) had > 4 children. Approximately half (199, 49.9%) of the women reported no modern contraceptive use in the postpartum period. Male condoms (116, 29.1%) were the most reported method of contraception; other methods reported included oral hormones (71, 17.8%) and intrauterine devices (13, 3.2%). Only disclosure of HIV status to male partner or relative (aOR = 2.0, 95% CI: 1.2–3.3; p = 0.01) and receipt of family planning counselling (aOR = 2.3, 95% CI: 1.1–4.8; p = 0.03) were positively associated with reported modern contraceptive use. Age, marital or educational status, religious affiliation, employment status, gravidity and parity were non-correlates.ConclusionsFamily planning counselling and disclosure of HIV status are modifiable positive predictors of contraceptive use among our cohort of postpartum HIV-positive women in rural Nigeria. Rates of unintended pregnancy and concomitant risk of MTCT could be significantly reduced through strategies that facilitate these correlates.Clinical trials registrationClinicaltrials.gov registration number: NCT 01936753; registered September 3, 2013.

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Factors associated with condom use among men and women living with HIV in Lilongwe, Malawi: a cross-sectional study

Cited by 18 publications

References 16 publications

Factors associated with condom use among HIV-positive women living in Atlanta, Georgia

Factors associated with condom use among HIV-positive women living in Atlanta, Georgia

<p>Understanding The Combined Effects Of The Knowledge Of HIV/AIDS Prevention Methods On Condom Use: A Case Of Njombe And Tanga Regions Of Mainland Tanzania</p>

Correlates of reported modern contraceptive use among postpartum HIV-positive women in rural Nigeria: an analysis from the MoMent prospective cohort study

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