Role of condom negotiation on condom use among women of reproductive age in three districts in Tanzania

Abstract

BackgroundHIV/AIDS remains being a disease of great public health concern worldwide. In regions such as sub-Saharan Africa (SSA) where women are disproportionately infected with HIV, women are reportedly less likely capable of negotiating condom use. However, while knowledge of condom use for HIV prevention is extensive among men and women in many countries including Tanzania, evidence is limited about the role of condom negotiation on condom use among women in rural Tanzania.MethodsData originate from a cross-sectional survey of random households conducted in 2011 in Rufiji, Kilombero and Ulanga districts in Tanzania. The survey assessed health-seeking behaviour among women and children using a structured interviewer-administered questionnaire. A total of 2,614 women who were sexually experienced and aged 15-49 years were extracted from the main database for the current analysis. Linkage between condom negotiation and condom use at the last sexual intercourse was assessed using multivariate logistic regression.ResultsPrevalence of condom use at the last sexual intercourse was 22.2% overall, ranging from12.2% among married women to 54.9% among unmarried (single) women. Majority of the women (73.4%) reported being confident to negotiate condom use, and these women were significantly more likely than those who were not confident to have used a condom at the last sexual intercourse (OR = 3.13, 95% CI 2.22-4.41). This effect was controlled for marital status, age, education, religion, number of sexual partners, household wealth and knowledge of HIV prevention by condom use.ConclusionConfidence to negotiate condom use is a significant predictor of actual condom use among women in rural Tanzania. Women, especially unmarried ones, those in multiple partnerships or anyone needing protection should be empowered with condom negotiation skills for increased use of condoms in order to enhance their sexual and reproductive health outcomes.

Attachment and Associated Sexual Health Behaviors of Heterosexual Mexican Housewives

“…Previous studies have reported such perceptions about condom use as more evident in women older than 25 years because these women believe that condom use indicates mistrust and infidelity (Crosby et al, 2013;Exavery et al, 2012). The present findings indicate misconceptions, myths, and a lack of knowledge about how STIs/HIV can be transmitted, that place Mexican heterosexual women who are housewives at risk.…”

“…Length of relationship was negatively correlated with condom use (Damani et al, 2009;Exavery et al, 2012;Varela Arévalo et al, 2011). This finding may reflect cultural and gender norms, such as the belief that housewives are safe in the marriage relationship, so that they do not request condom use with their partners, even when they suspect that the partner has had another sexual partner (Gómez Alvarez & Fonseca Hernández, 2012;Ragsdale, Gore-Felton, Koopman, & Seal, 2009).…”

“…Women in this study presented risk factors that could predispose them to STI acquisition, including low educational levels (≤9 years of school; 52%), initiation of sex before age 18 years (70%), more than three sexual partners in their lifetime (10%), and economic dependence and long-term partner relationships. Length of partner relationship was found to be negatively associated with condom use (Damani et al, 2009;Exavery et al, 2012;Varela Arévalo et al, 2011).…”

“…Exavery et al (2012) documented condom use in the most recent intercourse, as practiced by 12.4% of women who were married or living with a partner as married. Low educational level (9 years) and limited knowledge have been linked with limited condom use and misconceptions about STI prevention and transmission (Cinelli et al, 2008;Leval et al, 2011;Parada et al, 2010;Villegas Rodríguez, Ferrer Lagunas, Cianelli Acosta, Lara Campos, & Peragallo, 2011).…”

Prevention, treatment and future challenges of HIV/AIDS: A decade of INDEPTH research

“…Women bear the brunt of the epidemic in subSaharan Africa, and researchers at Rufiji HDSS in Tanzania found that women who had the confidence to negotiate condom use with their partners were much more likely to use condoms. The authors recommended empowering women with condom negotiation skills as a promising means of preventing infection [72]. A study at Nouna HDSS in Burkina Faso found that women who communicated with their partners about HIV were more likely to test for the virus.…”