Determinants of condom use to prevent HIV infection among youth in Ghana

Abstract

Purpose: To identify the psychosocial and behavioral factors that influence condom use to reduce the risk of human immunodeficiency virus (HIV) infection among young men in Ghana.

Methods: This study used a cross-sectional design in which data on a community-based sample of 601 young men, 15-24 years of age, were collected by a household survey instrument. For a conceptual framework, the study used constructs from the Health Belief Model (HBM) and Social Learning Theory (SLT) in the Ghanaian context.

Results: While 65% of the sexually active male respondents had used condoms at least once, only 25% had used condoms at last intercourse. Findings from multiple logistic regression analysis indicate that perceived susceptibility to HIV infection, perceived self-efficacy to use condoms, perceived barriers to condom use, and perceived social support were significant predictors of condom use. The most important finding, however, is that perceived barriers significantly interacted with perceived susceptibility and self-efficacy. Subjects who perceived a high level of susceptibility to HIV infection and a low level of barriers to condom use were almost six times as likely to have used condoms at last intercourse, compared to others. Similarly, young men who perceived a high level of self-efficacy to use condoms and a low level of barriers to condom use were nearly three times more likely to have used condoms at last intercourse when compared to others.

Conclusion: These results suggest that HIV prevention programs for youth should emphasize personal vulnerability to acquired immunodeficiency syndrome, instill in youth the self-belief that they can use condoms any time, and address how to overcome barriers to condom use.

PIP: Cross-sectional survey data on a community-based sample of 601 sexually active men aged 15-24 years, of mean age 20.8 years, were collected and analyzed in a study to identify the psychosocial and behavioral factors which influence condom use to reduce the risk of HIV infection among young men in Ghana. Most of the men were educated and 21% were married. While 64.9% had ever used a condom at least once, only 24.8% of the overall sample had used condoms at most recent intercourse. Significant predictors of condom use identified through multiple logistic regression analysis include perceived susceptibility to HIV infection, perceived self-efficacy to use condoms, perceived barriers to condom use, and perceived social support. Most importantly, however, perceived barriers significantly interacted with perceived susceptibility and self-efficacy. Subjects who perceived a high level of susceptibility to HIV infection and a low level of barriers to condom use were almost 6 times more likely than others to have used condoms at most recent intercourse, and subjects who perceived a high level of self-efficacy to use condoms and a low level of barriers to condom use were almost 3 times more likely than others to have used condoms at last intercourse. These findings suggest that HIV prevention programs for youth should stress personal vulnerability to AIDS, instill in youth the self-belief that they can use condoms at any time, and address how to overcome barriers to condom use.