Putting the C Back into the ABCs: A Multi-Year, Multi-Region Investigation of Condom Use by Ugandan Youths 2003–2010

Abstract

A major strategy for preventing transmission of HIV and other STIs is the consistent use of condoms during sexual intercourse. Condom use among youths is particularly important to reduce the number of new cases and the national prevalence. Condom use has been often promoted by the Uganda National AIDS Commission. Although a number of studies have established an association between condom use at one’s sexual debut and future condom use, few studies have explored this association over time, and whether the results are generalizable across multiple locations. This multi time point, multi district study assesses the relationship between sexual debut and condom use and consistent use of condoms thereafter. Uganda has used Lot Quality Assurance Sampling surveys since 2003 to monitor district level HIV programs and improve access to HIV health services. This study includes 4518 sexually active youths interviewed at five time points (2003–2010) in up to 23 districts located across Uganda. Using logistic regression, we measured the association of condom use at first sexual intercourse on recent condom usage, controlling for several factors including: age, sex, education, marital status, age at first intercourse, geographical location, and survey year. The odds of condom use at last intercourse, using a condom at last intercourse with a non-regular partner, and consistently using a condom are, respectively, 9.63 (95%WaldCI = 8.03–11.56), 3.48 (95%WaldCI = 2.27–5.33), and 11.12 (95%WaldCI = 8.95–13.81) times more likely for those individuals using condoms during their sexual debut. These values did not decrease by more than 20% when controlling for potential confounders. The results suggest that HIV prevention programs should encourage condom use among youth during sexual debut. Success with this outcome may have a lasting influence on preventing HIV and other STIs later in life.

Transactional sex and HIV risks – evidence from a cross-sectional national survey among young people in Uganda

“…In a meta-analytical review of studies, exposure to condom promotion messages in HIV prevention strategies was found to have great potential to reduce partners among those trading in sex, especially when delivered as part of a comprehensive risk reduction program ( 38 ). A study among Ugandan adolescents also indicated that condom promotion messages in early adolescence results in establishing a safe and lasting behavior pattern in young people ( 39 ). Hence, there is a need to emphasize the development of comprehensive risk reduction strategies that not only include components aimed at reducing multiple and concurrent sexual partners but also include negotiation and communication skills aimed at consistent condom use among young people.…”

Access to Education for Orphans and Vulnerable Children in Uganda: A Multi-District, Cross-Sectional Study Using Lot Quality Assurance Sampling from 2011 to 2013

“…Kampala); Table 1 shows how the data were distributed between four Uganda regions. Similar regional classifications have been used in previous studies [ 23 , 26 , 37 ]. The donor selected the districts surveyed each year; hence there is some variation in the geographical regions from one year to another ( S1 Table ).…”

“…This study uses secondary data sources collected using the Lot Quality Assurance Sampling method (LQAS), which has been used extensively to monitor and evaluate community-based programmes in Uganda and elsewhere. These data result from the roll out of LQAS as a national health sector monitoring system in Uganda, which has been supported by USAID since 2009 ( http://www.starelqas.ug ) [ 26 ]. Uganda used standard LQAS procedures [ 27 , 28 ].…”

“…At the district level the data are aggregated as a stratified sample, which results in a prevalence estimate with a 95% confidence interval that is no greater than +/-10%. The confidence interval also narrows considerably when multiple district data are aggregated [ 26 , 31 , 32 ]. We refer the reader to other sources for an in-depth description of the LQAS method [ 29 , 31 , 33 ].…”

Determinants of demand for condoms to prevent HIV infections among barmaids and guesthouse workers in two districts, Tanzania

“…Reports consistently indicate the greatest burden of HIV/AIDS being borne by least developed (and mostly poor) countries while sub-Sahara Africa (SSA) has remained the most affected region [ 2 ]. Targeting to implement health interventions to areas where the HIV/AIDS epidemic is much more concentrated is greatly recommended, and this includes identification of the groups at most risk of the infections and who are most vulnerable of the epidemic so that they can use appropriate preventive such as condoms and treatment products such as antiretroviral (ARV) drugs, coupled with proper health education and counseling services [ 1 , 3 ].…”