Risk Factors of Inconsistent Condom Use among Sexually Active Youths: Implications for Human Immunodeficiency Virus and Sexual Risk Behaviours in Malawi

Abstract

This study examines the risk associated with inconsistent use of condoms as a risk factor for human immunodeficiency virus/sexually transmitted infections (HIV/STIs) and sexual risk behaviours. The Malawi Demographic Health Survey 2010 data were used. Out of a sample of 2987 males and 9559 females aged 15–24 years, 511 males and 675 females were filtered in the present study. A Chi square test and logistic regression techniques were performed. About 147(28.7%) males and 240(35.6%) females reported inconsistent condom use. The likelihood of inconsistent condom use was higher among females with secondary/higher education (odds ratio’s (OR)=1.46), with more than one partner (OR=4.27), and married males (OR=8.76), with more than one sex partner (OR=1.78).There is a need to raise condom use awareness and improve sexual education about consistent condom use, especially among females, in order to curb the spread of HIV/STIs and reduce sexual risk behaviours.

Keywords

Sexually active youths inconsistent condom use sexually risky behaviour human immunodeficiency virus Malawi

Get full access to this article

View all access options for this article.

References

Adebowale

. (2014) Differential effect of wealth quintile on modern contraceptive use and fertility: Evidence from Malawian women. BMC Women’s Health 14(1): 40.

Ayoola

Sekoni

Odeyemi

(2014) Transactional sex, condom and lubricant use among men who have sex with men in Lagos State, Nigeria. African Journal of Reproductive Health 17(4): 90–98

Bandura

(2004) Health promotion by social cognitive means. Health Education & Behavior 31(2): 143–164.

Barker

Ricardo

(2005) Young Men and the Construction of Masculinity in Sub-Saharan Africa: Implications for HIV/AIDS, Conflict, and Violence. Washington, DC: World Bank.

Beksinska

Smit

Mantell

(2012) Progress and challenges to male and female condom use in South Africa. Sexual Health 9(1): 51–58.

Black

. (2011) Decision-making style and gender moderation of the self-efficacy–condom use link among adolescents and young adults: Informing targeted STI/HIV prevention programs. Archives of Pediatrics & Adolescent Medicine 165(4): 320–325.

Bukenya

. (2013) Condom use among female sex workers in Uganda. AIDS Care 25(6): 767–774.

Cai

. (2010) HIV prevalence and related risk factors among male sex workers in Shenzhen, China: Results from a time–location sampling survey. Sexually Transmitted Infections 86(1): 15–20.

Dalal

Jahan

Wang

S-M

(2014) Knowledge and perception of sexual health education and condom use among STI patients in India. International STD Research & Reviews 2(2): 74–87.

10.

Davidoff-Gore

Luke

Wawire

(2014) Dimensions of poverty and inconsistent condom use among youth in urban Kenya. AIDS Care 23(10): 1282–1290.

11.

Durevall

Lindskog

(2012) Economic inequality and HIV in Malawi. World Development 40(7): 1435–1451.

12.

Finer

Henshaw

(2006) Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspectives on Sexual and Reproductive Health 38(2): 90–96.

13.

Finer

Kost

(2011) Unintended pregnancy rates at the state level. Perspectives on Sexual and Reproductive Health 43(2): 78–87.

14.

Finocchario-Kessler

. (2012) ‘We weren’t using condoms because we were trying to conceive’: The need for reproductive counseling for HIV-positive women in clinical care. AIDS Patient Care and STDs 26(11): 700–707.

15.

Frost

Darroch

(2008) Factors associated with contraceptive choice and inconsistent method use, United States, 2004. Perspectives on Sexual and Reproductive Health 40(2): 94–104

16.

Ghimire

. (2011) Reasons for non-use of condoms and self-efficacy among female sex workers: A qualitative study in Nepal. BMC Women’s Health 11(1): 42.

17.

Global AIDS Response (2011) Global AIDS Response Progress Reporting 2012: Guidelines Construction of Core Indicators for Monitoring the 2011 Political Declaration on HIV/AIDS. Available at: http://www.unaids.org/sites/default/files/en/media/unaids/contentassets/documents/document/2011/JC2215_Global_AIDS_Response_Progress_Reporting_en.pdf (accessed 10 November 2014).

18.

Haddad

(2011) 2 Approval Sheet Family Planning for Women with HIV on Antiretroviral Therapy in Lilongwe, Malawi. [Master thesis, Emory University’s Electronic Thesis and Dissertation repository]. Available at: https://etd.library.emory.edu/view/record/pid/emory:bmhxv (accessed 13 March 2015).

19.

Huneeus

. (2014) Type of primary education is associated with condom use at sexual debut among Chilean adolescents. Sexually Transmitted Diseases 41(5): 306–311

20.

Hutton

. (2011) Alcohol use, anal sex, and other risky sexual behaviours among HIV-infected women and men. AIDS and Behavior 17(5): 1694–1704.

21.

Joint United Nations Programme on HIV/AIDS (UNAIDS) (2009) AIDS epidemic update. Available at: http://www.unaids.org/sites/default/files/media_asset/jc1700_epi_update_2009_en_0.pdf (accessed 3 June 2014).

22.

Joint United Nations Programme on HIV/AIDS (UNAIDS) (2010) Global Report on the AIDS Epidemic. Available at: http://search.unaids.org/search.asp?lg=en&search=2010%20report%20on%20the%20global%20aids%20epidemic (accessed 10 June 2014).

23.

Joint United Nations Programme on HIV/AIDS (UNAIDS) (2013) Available at: http://www.unaids.org/sites/default/files/sub_landing/files/20130607_Case%20Study_Malawi.pdf (accessed 08 April 2015).

24.

Joint United Nations Programme on HIV/AIDS (UNAIDS Malawi) (2014) Improving Promotion and Distribution of Condoms. Available at: http://unfpamalawi.org/index.php/component/content/article/35-home-page/49-improving-promotion-and-distribution-of-condoms.html (accessed 5 February 2015).

25.

Kimani

. (2013) Marital status and risk of HIV infection in slum settlements of Nairobi, Kenya: Results from a cross-sectional survey. African Journal of Reproductive Health 17(1): 103–113.

26.

Limaye

. (2012) Talking about sex in Malawi: Toward a better understanding of interpersonal communication for HIV prevention. Journal of Public Health Research 1(2): 117–125. doi: 10.4081/jphr.2012.e17.

27.

Malawi Demographic and Health Survey (2010) Preliminary Report. Macro International, Maryland, USA: MEASURE DHS; 2011. Available at: pdf.usaid.gov/pdf_docs/PNADU780.pdf (accessed 8 May 2014).

28.

Maluwa-Banda

Lunguzi

(2002) Baseline Survey Report on Meeting Development and Participation Rights of Adolescent Girls in Malawi. Lilongwe, Malawi: UNFPA.

29.

Marisen

(2014) Condom use in relation to the HIV/AIDS pandemic among adolescents: The case of some selected schools in Zomba, Malawi. Educational Research 5(7): 251–256. doi: http://dx.doi.org/10.14303/er.2014.115.

30.

Matseke

, (2012) Inconsistent condom use among public primary care patients with tuberculosis in South Africa. The Scientific World Journal 2012. Available at: http://www.hindawi.com/journals/tswj/2012/501807/ (accessed 11 May 2015).

31.

Mehra

. (2014) Inconsistent condom use among Ugandan university students from a gender perspective: A cross-sectional study. Global Health Action 7. Available at: http://www.globalhealthaction.net/index.php/gha/article/view/22942 (accessed 4 March 2015).

32.

Mooney

. (2013) Work-related violence and inconsistent condom use with non-paying partners among female sex workers in Adama City, Ethiopia. BMC Public Health 13(1): 771.

33.

Morris

. (2014) Factors associated with inconsistent condom use in adolescents with negative or unknown HIV status in Northwest Cameroon. AIDS Care 26(11): 1440–1445.

34.

Munthali

Chimbiri

Zulu

(2004) Adolescent Sexual and Reproductive Health in Malawi: A Synthesis of Research Evidence. Occasional Report No. 15. Alan Guttmacher Institute. New York, NY and Washington, DC. Available at: https://www.guttmacher.org/pubs/2004/12/01/or_no15.pdf (accessed 14 October 2014).

35.

Nagarajan

. (2013) Self-report of STI symptoms, inconsistent condom use and condom non-use are poor predictors of STI prevalence among men who have sex with men. Journal of AIDS & Clinical Research 4(212): 2. doi: 10.4172/2155-6113.1000212.

36.

Nakaie

. (2014) Family planning practice and predictors of risk of inconsistent condom use among HIV-positive women on anti-retroviral therapy in Cambodia. BMC Public Health 14(1): 170.

37.

National Statistical Office (NSO) and ICF Macro (2011) Malawi Demographic and Health Survey 2010. Zomba, Malawi, and Calverton, Maryland, USA: NSO and ICF Macro. Available at: http://dhsprogram.com/pubs/pdf/FR247/FR247.pdf (accessed 9 April 2014).

38.

Patel

. (2014) Individual and interpersonal characteristics that influence male-dominated sexual decision-making and inconsistent condom use among married HIV serodiscordant couples in Gujarat, India: Results from the Positive Jeevan Saathi Study. AIDS and Behavior 18(10): 1970–1980.

39.

Paul

(2015) An association between neighbourhood wealth inequality and HIV prevalence in sub-Saharan Africa. Journal of Biosocial Science 47(3): 311–328. doi:10.1017/S0021932013000709.

40.

Stutterheim

. (2013) Factors contributing to inconsistent condom use among heterosexual men in Curacao. Culture, Health & Sexuality 15(4): 420–433.

41.

United Nations Population Fund (UNFPA) (2011) Annual Report. DELIVERING RESULTS in a world of 7 billion. Available at: http://www.unfpa.org/sites/default/files/pub-pdf/16434%20UNFPA%20AR_FINAL_Ev11.pdf (accessed 23 February 2015).

42.

Wang

. (2015) Prevalence of consistent condom use with various types of sex partners and associated factors among money boys in Changsha, China. Journal of Sexual Medicine 12(4): 936–945. doi: 10.1111/jsm.12821.

43.

Wang

. (2013) Unsafe sex and STI prevalence among HIV-infected adults in Guangzhou, China: Opportunities to deamplify sexual HIV transmission. AIDS and Behavior 17(3): 1137–1143.

44.

Wirtz

. (2015). Sexual violence, condom negotiation, and condom use in the context of sex work: Results from two West African countries. JAIDS: Journal of Acquired Immune Deficiency Syndromes 68 (Supplement 2): S171–S179.