Chandiwana, Nomathemba Chiwoneso2008-07-152008-07-152008-07-15http://hdl.handle.net/10539/5057Introduction South Africa is one of the countries hardest hit by HIV/AIDS. Of particular concern, new infections among young people, especially young women and girls are on the rise. Despite widespread awareness and prevention campaigns, the prevalence of HIV and deaths caused by AIDS are still on the increase, whereas condom use particularly in rural areas remains low. Consistent condom use is central to the prevention of unwanted pregnancies, HIV and other STIs, yet young men and women alike are hesitant to use condoms because of threats to their relationships, cultural roles and at times economic survival. Purpose The purpose of this study is to identify socio-cultural and behavioral factors that influence condom use among youths in Limpopo province, South Africa. This adds to a growing body of knowledge on the determinants of condom use and how they might shape effective HIV prevention programs. Objectives 1. To conduct a secondary data analysis that examines the determinants of condom use, for men and women separately in relation to the following factors: Socio-demographic characteristics- age, education, marital status, migration and iv socio-economic status Sexual behavior characteristics- partnership type (spousal, non spousal, or both), age at sexual debut, number of lifetime sexual partners, contraceptive use (females only) and HIV-status Socio-cultural characteristics - perceived risk of HIV infection, condom self efficacy (males only), partner communication on sex, condoms, HIV and other STI’s, beliefs on gender norms, attitudes towards gender violence, knowledge on HIV/AIDS and HIV/AIDS related stigma To compare the results of this analysis to other national studies on condom use among young people. To use the results of this analysis to make recommendations to improve HIV control in rural South Africa.Methods This study is a secondary analysis of data collected from a sample of 2236 sexually active young people aged between 14-35 years in Limpopo province, South Africa. The data used in this study is part of a wider public health intervention, the Intervention with Micro-finance for AIDS and Gender Equity (IMAGE) study. STATA 8.0 was used to analyze data in bivariate and multivariate analyses to assess determinants of consistent condom use and condom use at last sex for males and females separately as the patterns of associations are likely to differ between them. Results Overall condom use in this population was low: less than a quarter of respondents used condoms consistently and less than one third of men and women used condoms at last sex. This is especially true of females, married couples and those who have multiple partners. In multivariate analysis, significant predictors of consistent condom use for both sexes included good communication, older age at sexual debut, low risk perception of HIV infection, progressive attitudes towards gender violence and high HIV-related stigma. High condom self-efficacy, defined as the intention to pick up or purchase condoms with the intention of use, was the most powerful predictor of both condom use indices among males. Among females only, having fewer than three lifetime sexual partners was positively associated with using condoms consistently. Lastly, females who used condoms as their main method of contraception were up to 20 times more likely to use them consistently and at last sex. Conclusions HIV prevention programmes in this population should focus on delaying sexual debut, increasing perceived risk of HIV infection, encouraging partner communication, making condoms more easily accessible to young men and addressing gender inequalities. Furthermore, the dual protection offered by condoms against unwanted pregnancies and against HIV and other STI’s should be emphasized in this population as it plays an important role in the prevention of HIV.2279747 bytes124098 bytesapplication/pdfapplication/pdfencondom useyouthgenderHIVLimpopo Province, South AfricaThesis