HIV prevention and marriage: peer group effects on condom use acceptability in rural Kenya

Abstract

The twofold function of condom use - contraception and sexually transmitted disease protection - should be taken into account when understanding attitudes towards this practice. Emphasis on the interpretation of condom use as a protective practice conflicts with the norms of fidelity and trust, which regulate marriage. The alternative interpretation of condom use as a contraceptive method may be less problematic. This paper analyzes the extent to which the attitude of married men and women towards condom use with their spouses, and their actual use of condoms within marriage, are affected by their expectations about the dominant attitudes and behaviors in their peer group. I expect that a social consensus on understanding condom use as an HIV-preventive behavior will not make this practice more acceptable within marriage, while social acceptance of modern contraception and, more specifically, of the use of condoms for contraceptive purposes will. Two waves of a longitudinal survey from 1996 to 1999 in rural Kenya are analyzed using fixed-effects regression. Social support for each function of condom use is measured with indicators of the proportion of individuals in the peer group that use condoms for a particular purpose or have a positive attitude towards each of the uses, according to the respondent. The results support the hypothesis for men, but are inconclusive for women.

Keywords: Africa; Condom use; Contraception; Fidelity; HIV/AIDS; Kenya; Marriage; Social networks.