Factors associated with consistent condom use among women in Botswana
Date
2017
Authors
Mlandu, Chenai
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Abstract
Consistent condom use is one of the most effective ways of reducing sexual transmission of HIV. Apart from risky sexual behavior, gender inequalities are increasingly being recognized as crucial influences of unsafe sex practice. Botswana has high HIV prevalence and women are at greater risk of HIV. Therefore, this study assessed the prevalence and associated factors of consistent condom use among women in Botswana.
Methods
The study was a secondary data analysis using data drawn from a national cross-sectional household-based survey in 2011.The primary study sampled 639 women, aged 18 and above, using a multi-stage procedure, in which 55 Primary Sampling Units (PSUs) were randomly sampled and thereafter 20 households in each PSU were randomly selected. An eligible woman was sampled in each household. A standardised questionnaire, self-administered using PDAs and supported by trained female research assistants, was used to collect data. Secondary data analysis was restricted to 480 sexually active women who were in a heterosexual relationship and responded to the condom use questions. Logistic regression analysis, accounting for clusters, was used to explore the association between consistent condom use and explanatory predictor variables.
Results
Approximately 43% of the women reported consistent condom use in the year before the survey. Consistent condom use was more likely if women had attained high levels of education (aOR=2.17; 95% CI=1.34-3.51) and expressed high relationship power (aOR=1.59; 95% Cl=0.93-2.71). However, women were less likely to report consistent condom use if they were; ever physically abused by partner (aOR=0.45; 95% Cl=0.25-0.84), cohabiting with current partner (aOR=0.33; 95% CI=0.13-0.83) and had more than one sexual partner in year preceding the survey (aOR= 0.63; 95% CI=0.43-0.91).
Conclusion
Women’s risk of HIV may be heightened by power imbalances that affect sexual decisions in heterosexual relations. Our study findings highlight the importance of addressing risky sexual behavior and gender inequalities to curb the spread of HIV. Effective HIV programs promoting condom use should have targeted condom messages on cohabiting and polygamous relationships, and gender responsive strategies encompassing safe sex skills, violent and controlling behaviors change.
Description
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Science in Infectious Disease Epidemiology
Johannesburg, November 2017.