Consistent and Correct Use of Condoms With Lubricants and Associated Factors Among Men Who Have Sex With Men from the Ghana Men's Study II: Protocol for a Mixed Methods Study

Abstract

Background: Men who have sex with men (MSM) experience a disproportionate burden of HIV infection globally, including in Ghana. The use of condoms with lubricants correctly and consistently plays a vital role in reducing the number of new HIV infections among MSM. However, there are concerns about the consistent and correct use of condoms and lubricants among MSM in Ghana. In this regard, there is a need to understand context-specific factors associated with consistent and correct condom use with lubricants.

Objective: This study aims to determine the current scope of consistent and correct use of condoms with lubricants, associated factors, interventions, and user- and service-related challenges on correct condom and lubricant use among the MSM population in Ghana.

Methods: The study will use a mixed methods study approach. First, a retrospective analysis of the Ghana Men's Study II data set involving 4095 MSM will be conducted to determine the scope of consistency and correct use of condoms with lubricants as well as associated factors. The data will be imported into STATA (version 17; StataCorp LLC) to treat missing data and outliers before the analysis. Bivariate and multivariate logistic regression analyses will be conducted to determine the associated factors of consistent condom use with lubricants. All statistical analyses will be done at a 95% CI, with significant differences at P<.05. Second, in-depth interviews with a purposive sample of about 15-20 stakeholders will also be conducted to understand contextual issues regarding the factors identified, identify existing interventions for correct condom and lubricant use, user and service-related challenges, and how best to address those challenges from the stakeholders' perspectives. For qualitative data, thematic analysis will be conducted using Atlas.ti version 23.1.1.

Results: Qualitative and quantitative results will be triangulated together with systematic review results, and key findings will be highlighted and used to guide the development of a predictive model for improving correct and consistent condom use with lubrication among MSM. This protocol paper, part of a doctoral study by the first author (RA), received approval from the Research and Ethics Committee of the University of Johannesburg on May 10, 2024. Data collection commenced on August 20, 2024, and the expected results will be published by October 2025.

Conclusions: Results from qualitative interviews and secondary data analysis will be triangulated to develop a predictive model to strengthen the correct and consistent use of condoms with condom-compatible lubricants among MSM and other key population groups in Ghana and other parts of sub-Saharan Africa for future pandemic preparedness, policy making, and targeted budget allocation.

International registered report identifier (irrid): DERR1-10.2196/63276.

Keywords: Africa; Ghana; Ghana Men’s Study; HIV; condom; consistent condom use; lubricant; men who have sex with men; mixed methods; protocol; qualitative; quantitative.