Condom use and associated factors among HIV-positive patients accessing care at a private tertiary health institution in the southwest, Nigeria

Objective: This study aimed to assess the knowledge, attitude and practice towards condom utilization and other associated factors among people living with HIV/AIDS enrolled in the Virology clinic in Babcock University Teaching Hospital (BUTH) Ilishan, Ogun state, Nigeria. Methods: This cross-sectional study was conducted among 285 ART users selected using a systematic random sampling method. The minimum sample size was estimated using the formula z2pq/d2 and a 24% prevalence extracted from a previous similar study. Data were elicited using a structured interviewer-administered questionnaire, analyzed using SPSS version 20, and presented as tables. The Chi-square test was used to assess associations between categorical variables. The level of significance was set at the 95% confidence interval with a p-value of 0.05.Results: From the total respondents, 180(63.2%) were females, 93.7% had good knowledge, 141(49.5%) believed ARV prevents transmission of HIV and 144 (50.5%) strongly agreed that condom reduces sexual pleasure. Majority 254 (89.1%) were currently using condoms, 131 (46.0%) used a condom consistently, while 108 (37.9%) frequently use a condom during sexual intercourse. The Use of condoms had statistically significant associations with occupation (p<0.001), married at pre-diagnosis of HIV (p<0.001), married at post-diagnosis of HIV (p<0.001) and education (p= 0.015).Conclusion: The majority of the respondents had good knowledge and were using condoms. Discussions on safe sex and improved positive attitudes towards condom-use should, however, be encouraged further

HIV-prevention measures on a university campus in South Africa ­ perceptions, practices and needs of undergraduate medical students

Background: Young adults such as university students are considered to be a key population for HIV-prevention efforts. This study aimed to determine the perceptions, practices and needs of undergraduate medical students regarding HIV-prevention measures available on campus. Methods: The research design was descriptive cross-sectional. Data were collected using an anonymous, self-administered questionnaire distributed to all 745 undergraduate medical students in the School of Clinical Medicine, University of the Free State, South Africa, of whom 470 responded (63.1%). Results: Almost half (45.5%) of all respondents across the five academic years had received information about available HIV-prevention measures on campus. Most reported that information had been received during lectures (59.7%) and only 24.2% from the local health clinic on campus. The findings also revealed that 14.2% of students had used at least one prevention measure in the past, while the majority of students (70.2%) used abstinence as an HIV-prevention measure. A large percentage of all the students (47.6%) had been tested for HIV before the start of the study. Two-thirds (67%) of students indicated that the current HIV-prevention services on campus were not sufficient. Conclusion: Medical students received HIV-prevention information as part of their curriculum but this was deemed not to be sufficient. This study suggests that tertiary education institutions should evaluate the effectiveness of strategies currently in place for the distribution and awareness of HIV-prevention measures and sexual health issues affecting students, using a student-centred approach

Determinants of risky sexual behaviours among adolescents in Central African Republic, Eswatini and Ghana: evidence from multi-indicator cluster surveys

Despite the declining HIV/AIDS prevalence globally, nearly half of all new HIV infections still occur among youth, especially in sub-Saharan Africa. While determinants of risky sexual behaviour have received copious attention in the literature, we still lack multi-country studies that track regional changes in sexual risk among youth in sub-Saharan Africa. This study seeks to fill part of this gap by identifying the determinants of risky sexual behaviours among adolescents in Ghana, Central African Republic (CAR) and Eswatini (formerly Swaziland). We used nationally representative sample data from the Multi Indicator Cluster survey, round four (MICS4). Results of the descriptive analysis show that overall consistent condom use is still extremely low in sub-Saharan Africa. In Ghana, only 8.5% of male youth and 7% of female youth consistently use condoms. In CAR this figure is 8% and 4% in male youth and female youth respectively. In Eswatini, with one of highest HIV prevalence in the world, the prevalence of consistent condom use is at 29% in males and 20% in females, higher than both in Ghana and CAR. Results of hierarchical models show that age at first sex does not predict risky sexual behaviour in Ghana, but it does predict risky sexual behaviour in CAR although only among young males. In Swaziland, age at first sex predicts risky sexual behaviour in both male and female youth but the relationship is not in the expected direction. Low socio-economic status predicts inconsistent condom use in all the three countries, but only among young females. This paper provides relevant policy lessons and recommendations

Modalités de suppression du préservatif en dehors du mariage à Brazzaville

Le préservatif est une méthode de protection capitale en dehors du mariage. Cette étude a eu pour objectifs de déterminer le taux d'utilisation du préservatif en dehors du mariage, déterminer les modalités d'utilisation du préservatif en dehors du mariage, déterminer les modalités de suppression du préservatif en dehors du mariage. Matériel et méthodes : Il s'est agi d'une enquête transversale du 01 janvier 2015 au 31 Décembre 2016, 24 mois à l'hôpital de base de Talangaï à Brazzaville portant sur l'introduction du préservatif dans la relation, la régularité de son l'utilisation, les motifs,conditions et le délai de sa suppression. Résultats : Sur 1103 couples vivant une relation en dehors du mariage depuis au moins 1 an interrogés, 89,5% ont avoué avoir débuté les rapports sexuels avec le préservatif. L'introduction du préservatif lors du premier rapport sexuel a été motivée pas la crainte du VIH et autres IST dans 56,1% de cas et la crainte de la grossesse dans 36% de cas. Après un an,734 couples soit 74,4% avaient supprimé le préservatif. La raison principale ayant motivé cette suppression chez les femmes et les hommes étant le passé sexuel supposé acceptable du partenaire et/ou sa bonne santé apparente respectivement dans 47,8% et 39,2% de cas.Le préservatif est largement utilisé lors du premier rapport sexuel à Brazzaville. Il est supprimé au fil du temps sans connaissance du statut sérologique de l'autre dans la plupart des cas. Ce constat indique un écart important entre le niveau de connaissance de la population sur le VIH/SIDA et leurs pratiques

La perception des anti-retro-viraux (ARV) determine negativement l'utilisation de preservatif par la population a Kisangani; RDC

Introduction: La crainte d'une menace d'impact negatif sur la prevention contre le VIH/Sida est ressentie dans les pays en developpement (et RDC) a l'ere d'acces gratuit aux ARV. Mais peu est connu a ce sujet dans notre pays. Objectif : Explorer l'utilisation de preservatif dans le contexte d'acces aux antiretroviraux a Kisangani Materiel et methodes : Une etude transversale a ete realisee. Nous avons utilise les donnees de l'etude investiguant les comportements a risque de VIH chez les donneurs benevoles de sang de Kisangani. Resultats : 175 sujets ont ete enquetes : 62 (35;5) utilisaient systematiquement le preservatif et 113(64;5) pas. A l'analyse bi variee; l'utilisation fidele de preservatif etait negativement liee a : l'abus de l'alcool avant les rapports sexuels occasionnels (OR=0;33 [0;17- 0;63]; p=0;0064); la perception des ARV capable de guerir le VIH (OR=0;5 [0;266-0;94]; p=0;031) et a la perception de preservatif devenu inutile a l'ere des ARV (OR=0;47[0;23- 0;97]; p=0;043). Les autres facteurs n'y etaient pas statistiquement lies. A l'analyse multi variee binaire; les facteurs suivants ont ete retenus comme limitant l'utilisation fidele de preservatif : la religion (musulmane); l'abus de boissons alcoolisees et les perceptions erronees des Anti-Retro-Viraux Conclusion : La crainte de la menace d'impact negatif sur la prevention contre le VIH/Sida est justifiee avec l'acces aux ARV a Kisangani. La pratique sexuelle non protegee est une realite frequente dans cette population. L'education; l'information et la communication pour un comportement responsable doivent accompagner l'acces aux ARV. Une nouvelle strategie de prevention contre le VIH/Sida dans cette ville est donc recommandee

Ecological Association between HIV and Concurrency Point-Prevalence in South Africa's Ethnic Groups

HIV prevalence between different ethnic groups within South Africa exhibits considerable variation. Numerous authors believe that elevated sexual partner concurrency rates are important in the spread of HIV. Few studies have; however; investigated if differential concurrency rates could explain differential HIV spread within ethnic groups in South Africa. This ecological analysis; explores how much of the variation in HIV prevalence by ethnic group is explained by differential concurrency rates. Using a nationally representative survey (the South African National HIV Prevalence; HIV Incidence; Behaviour and Communication Survey; 2005) the HIV prevalence in each of eight major ethnic groups was calculated. Linear regression analysis was used to assess the association between an ethnic group's HIV prevalence and the point-prevalence of concurrency. Results showed that HIV prevalence rates varied considerably between South Africa's ethnic groups. This applied to both different racial groups and to different ethnic groups within the black group. The point-prevalence of concurrency by ethnic group was strongly associated with HIV prevalence (R2 = 0.83; p = 0.001). Tackling the key drivers of high HIV transmission in this population may benefit from more emphasis on partner reduction interventions

Level of Awareness and Uptake of the Female Condom in Women Aged 18 to 49 Years in Bindura District; Mashonaland Central Province; Zimbabwe

Zimbabwe introduced the female condom in 1997; but acceptance was slow. A study was conducted to determine its level of awareness and uptake in women aged 18 to 49 years at Bindura Provincial Hospital; and at Chipadze and Chiwaridzo council clinics. A descriptive cross-sectional study design was used. A total of 242 eligible consenting respondents were selected using simple random sampling. Data were processed using the Statistical Package for Social Sciences (SPSS) software version 16. Data revealed that 81.4 of the respondents had heard about the method. Most respondents 88 (36.4) had heard about female condoms from nurses. However; 53.3 had not received health education on the method from healthcare providers. Knowledge of the female condom was low at 36.3 and most respondents (83.5) had not used it. The major reasons cited for failure to use the method were unavailability (19.8) and partner refusal (17.8). Of the 16.5 who used the female condom only 4.1 used it consistently. Female condom uptake was very low at 16.1. Knowledge of the method was associated with its uptake (?2 = 86; p 0.05). Pearson's correlation was used to examine the relationship between awareness and uptake of the method. It indicated a weak positive linear relationship (r

Reproductive behaviour among women on antiretroviral therapy in Botswana: mismatched pregnancy plans and contraceptive use

Understanding pregnancy planning and contraceptive use is important in preventing unplanned/unwanted pregnancies among women on antiretroviral therapy (ART). Through a cross-sectional survey of 155 women living with HIV on ART in Botswana (mean age = 36); bivariate/multivariate analyses were used to identify and understand pregnancy planning and contraceptive use. Women who did not plan to have a child (n = 85) were older; less educated; had more children and worried about stigmatisation from family and healthcare workers (HCWs). Multivariate analyses found age (OR:3.41; CI:1.57-7.45; p = 0.002); perceived stigmatisation from family and healthcare workers (OR:3.62; CI:1.47-8.96; p = 0.005); and believing it is irresponsible for women living with HIV to want a child (OR:2.40; CI:1.10-5.24; p = 0.028) to be significantly associated with not planning to have a child. Although reported condom use among 85 women who did not plan to have a child was nearly 90; a total of 26 of these women (34) believed they did not have control over condom use. Lack of contraception was reported by 6 women who did not plan a child; this; coupled with the lack of control over condom use; puts unmet need for contraception at 38 Most women reported feeling comfortable talking with HCWs about contraceptives. However; almost a quarter of the women indicated they were infrequently advised about contraceptives at ART clinics. This study found discordance between pregnancy planning and contraceptive use among women on ART. Lack of control over condom use coupled with low hormonal contraceptive use creates unmet need for contraception and increases the risk of unwanted pregnancies. Regular clinic visits for women on ART present excellent opportunities to address contraceptive needs in a considerate and comprehensive manner

Awareness and use of modern contraceptives among physically challenged in-school adolescents in Osun State, Nigeria

This study assessed awareness and use of modern contraceptives among physically challenged in-school adolescents in Osun State, Nigeria. A cross-sectional study was carried out among 215 adolescents in the special schools in the state. A pretested semi-structured questionnaire was administered by trained interviewers. Data analysis was done using SPSS 17 and statistical level of significance was set at p< 0.05. The mean age of the respondents was 15.5years and more than half of them (56%) were males. Only about two fifths of them (38%) had ever heard about modern contraceptives. More males, older adolescents and visually impaired respondents had significantly heard about modern contraceptives compared with females, younger ones and those with other challenges at p-values of 0.026, 0.001 and 0.003 respectively. Only 34% of sexually experienced respondents had used a modern contraceptive method. The male condom was the most commonly used method. Afr J Reprod Health 2014; 18[2]: 87-96)

Coital Frequency and Condom Use in Monogamous and Concurrent Sexual Relationships in Cape Town; South Africa

The importance of concurrency (overlapping sexual partnerships in which sexual intercourse with one partner occurs between two acts of intercourse with another partner) in driving HIV transmission in hyperendemic settings remains controversial. A modelling study concluded that the role of concurrency in accelerating the spread of HIV is dramatically reduced by coital dilution (the reduction in frequency of sex acts per sexual partner; as a result of acquiring additional partners). We recently examined self-reported data on coital frequency and condom use during monogamous and concurrent relationship episodes from a survey in three communities with a high HIV prevalence. A key question in our analysis was if there is evidence for coital dilution and/or increased condom use during episodes of concurrency

Knowledge and Attitudes about and Practices of Condom Use for Reducing HIV Infection among Goma University Students in the Democratic Republic of Congo

The Democratic Republic of Congo (DRC) is experiencing increasing human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) in young adults. This is despite the government's widespread campaign on HIV/AIDS awareness. In this study; high-risk university students who engage in casual sex; but who have good literacy skills; were surveyed to ascertain whether the education campaigns in the country influenced their condom use practice. This study sought to determine Goman University students' knowledge and attitudes about and practices of condom use for the purpose of reducing HIV infection. A descriptive cross-sectional quantitative study; using a self-administered questionnaire; was carried out. The ages of the students varied between 18 and 33. Most of them were men: 111 (80); 129 (93) were single; and most participants were Protestants (61; 44) and Roman Catholics (57; 41). The majority of participants (137; 99) knew about condoms; while 132 (96) were aware that condoms were available from and sold by pharmacies. Seventy-two (52 ) understood that condoms helped to prevent HIV; pregnancy and sexually transmitted infections (STIs). Ninety-four (68) said that they knew how to use a condom; while 111 (80) stated that the price of condoms was not a barrier to usage thereof. One hundred and two (74) suggested that the university should supply students with condoms. Ninety-one (66) were sexually active and 98 (71) of participants reported that they had unprotected sex. Condom awareness was high and information was available from varying sources. Condoms were accepted as a means to prevent HIV/AIDS; STIs and pregnancy. Some ethnic groups disapproved of condom use because of religious and cultural beliefs. Consistent use of condoms was low in Goma University students

Contraceptive knowledge and practices among pregnant females in Lower Umfolozi District War Memorial Hospital; KwaZulu-Natal

In South Africa there has been a decline in the proportion of women who have ever used contraception; while 30 to 50 of women present with unwanted and unplanned pregnancies. This study aimed to describe the contraceptive knowledge and practices among women aged 18 to 49; attending the antenatal clinic at LUDWM Hospital in KwaZulu-Natal; by means of a cross-sectional survey. The majority of the 286 respondents (76.6) were aged 18 to 29 years; 65.8 of the pregnancies were unplanned. Most (80.1) knew about injectable contraception. Condoms were used by 85.3; followed by injectable contraception (80) and oral contraceptives (62.5). Contraception was discontinued because of irregular vaginal bleeding (14) or weight gain (3.8). Of the women who planned for this pregnancy; 69 were using oral contraceptives. The general knowledge of modern contraception among the women was good; condoms were the contraception of choice; and most accessible. Employed women used emergency contraception and the withdrawal method more often than unemployed women. However; the most common forms of contraception used by both employed and unemployed women were condoms; oral contraceptives and injectable contraception. In this study the high unemployment rate; low education and limited access to modern contraception were associated with low contraceptive utilisation and high rates of unwanted pregnancies

Perceptions of youth on the use of condoms for HIV prevention in Capricorn District, Limpopo Province, South Africa

Despite the fact that condoms are very effective against Sexually Transmitted Infections (STIs) and Human Immunodeficiency Virus transmission (HIV); many people who are at risk do not use them. Latex condoms provide an essentially impermeable barrier to particles the size of HIV and other STI pathogens. The primary aim of this study was to determine the perceptions of youth on the use of condoms for HIV prevention in the Capricorn District of the Limpopo Province; South Africa. A qualitative; exploratory and descriptive design was used. The population included all youth from the ages of 15 to 19 years who attended two primary health care clinics in the Capricorn District. A non-probability purposive sampling method was used. Purposive sampling was used to include participants to participate in the study. Data were collected through unstructured interviews from 15 participants. Interviews were conducted until data saturation was reached; after which the data obtained were analysed qualitatively by open-coding method. Findings revealed four themes; namely; paradoxical attitudes towards consistent condom use related to fear of sexual intercourse and a need to prevent HIV transmission; casual usage of condoms perceived as having positive and negative results; responsibilities of youth to insist on condom use during sexual intercourse; and programme available to help youth with consistent use of condoms. Health education themes that should be included in the programme for educating the youth on the use of condoms for HIV prevention were recommended

Knowledge, attitude and practice (KAP) of sandwich under graduate students of Delta State University, Abraka, Nigeria on condom use in the prevention of sexually transmitted infections (STLS) and unwanted pregnancy

The study investigated the knowledge, attitude and practice (KAP) of sandwich under graduate students of Delta State University, Abraka, on condom use for the prevention of sexually transmitted infections (STls) and unwanted pregnancy. This is with a view of assessing the relevance of knowledge to attitude and practice. Three hypotheses were generated to guide the study. A self designed (KAP) questionnaire with 18 questions items were used to generate information. The sample was 610 students. Percentages and chi- square statistics were used to analyze the data. It was found that students had good knowledge of condom use towards the prevention of STls and unwanted pregnancy. There was also a relationship between knowledge and attitude. Males and females do not differ in their knowledge, attitude and practice of condom use. It was recommended that family and sexuality education be a part of the school curriculum, while the media should continuously be used to campaign for the use of condom in the prevention of STls and unwanted pregnancy

HIV/AIDS Misconceptions may be Associated with Condom Use among Black South Africans: an Exploratory Analysis

In South Africa; approximately 20of 15-49-year-olds are infected with HIV. Among black South Africans; high levels of HIV/AIDS misconceptions (e.g. HIV is manufactured by whites to reduce the black African population; AIDS is caused by supernatural forces or witchcraft) may be barriers to HIV prevention. We conducted a cross-sectional study of 150 young black adults (aged 18-26; 56males) visiting a public clinic for sexually transmitted infections; to investigate whether HIV/AIDS misconceptions were related to low condom use in main partner relationships. We assessed agreement with HIV/AIDS misconceptions relating to the supernatural (e.g. witchcraft as a cause of HIV) and to genocide (e.g. the withholding of a cure). In multivariate models; agreement that `Witchcraft plays a role in HIV transmission' was significantly related to less positive attitudes about condoms; less belief in condom effectiveness for HIV prevention; and lower intentions to use condoms among men. The belief that `Vitamins and fresh fruits and vegetables can cure AIDS' was associated with lower intentions among men to use condoms. Women who endorsed the belief linking HIV to witchcraft had a higher likelihood of unprotected sex with a main partner; whereas women who endorsed the belief that a cure for AIDS was being withheld had a lower likelihood of having had unprotected sex. Knowledge about distinct types of HIV/AIDS misconceptions and their correlates can help in the design of culturally appropriate HIV-prevention messages that address such beliefs

HIV/AIDS related knowledge and perceived risk associated with condom use among adolescents in Uganda

While considerable attention has been paid to sexual behaviors among HIV high-risk populations in Africa, few studies have looked at the adolescent population. Using data from the 2004 National Survey of Adolescents in Uganda, logistic regression models were fitted to examine the odds that HIV/AIDS related knowledge and perceived risk of HIV infection are associated with condom use among adolescents. After including demographic measures, findings indicated that correct knowledge of condom use, as well as positive attitudes towards the use of condoms are associated with the likelihood that adolescents used condoms. Self assessment of the risk of HIV infection was not predictive of condom use, nor was knowing someone with AIDS. These findings further emphasize the need to encourage condom use and help protect adolescents at risk of HIV infection (Afr J Reprod Health 2011; 15[1]: 57-63)

Sexual Activity during Pregnancy: a Questionnaire-Based Study

The objective of the study was to determine changes in frequency of sexual activity during pregnancy. A prospective study was conducted using a structured questionnaire to interview 611 healthy pregnant women at a regional hospital in KwaZulu-Natal. Data were analysed using descriptive statistics. Five hundred and fifty-six (91.0 ) of the 611 women were sexually active during pregnancy. Sexual desire was increased in 102 (18); decreased in 299 (40) and was unchanged in 210 (34). Four hundred and twenty-two (69) engaged in sexual activity until the third trimester of pregnancy. Three hundred and seventy-nine (62) used condoms. The majority (63) found it easier to discuss the topic of sexual activity with midwives rather than with doctors. One hundred and thirty-eight (23) experienced adverse events attributed to sexual intercourse during pregnancy. Religious and traditional practices played a minor role in guiding the practice of sexual activity during pregnancy. Twenty-eight (5) of the 611 women were guided by religious rules while 27 (4) were guided by traditional rules. Our findings confirm that sexual activity is commonly practised in pregnancy. Given the high HIV rates and sexually transmitted infections in the local population; this has important implications for information provided during antenatal care

The Effects of Psychological Inoculation on Cognitive Barriers Against Condom Use in Women with HIV: A Controlled Pilot Study

Past studies have shown that in attempts to prevent HIV; health education yields little change in condom use. The reason may be that education fails to target barriers for changing behaviour. The present controlled pilot study tested whether psychological inoculation (PI) reduces such barriers for using male condoms. Twenty-two Nigerian women with HIV were randomly assigned to receive PI or health education (control). In the PI condition; women learned to refute sentences reflecting barriers against condom use; while controls learned how to use condoms and the consequences of their non-use. Barriers for condom use; self-efficacy to negotiate condom use with partners and actual condom use were self-reported before and one week after interventions. Results revealed that only in the PI group were there statistically significant increases in condom use negotiating self-efficacy and reductions in barriers concerning motivation; sexual satisfaction and partners. Controls reported no statistically significant changes. However; actual reported condom use was unchanged in both groups. Thus; it is feasible to conduct PI interventions in an African sample of HIV patients. Furthermore; PI can reduce cognitive barriers for condom use; while health education yields little changes in such outcomes over time. If replicated in larger samples with longer follow-ups; these findings could eventually have implications for HIV prevention in several world regions

Factors Influencing Condom Use Among Women in Ghana: an HIV/AIDS Perspective

Although in Ghana information on HIV infection and prevention; both in terms of quality and quantity; has increased considerably within the past few years; available literature indicates that behaviour change is yet to correspond with the amount of information and education provided. The objective of this study is to examine factors that influence condom use among women in Ghana in the context of HIV/AIDS prevalence. Data for this study are from the 2003 Ghana Demographic and Health Surveys (GDHS) and the study population (N=5 691) was analysed using logistic regression with the Health Belief Model (HBM) as an explanatory tool. The outcome variable for this study is condom use during last sexual intercourse. The HBM identifies perception of HIV/AIDS risks; awareness of its seriousness; knowledge about prevention; and confidence in condom use as predictors of safe sexual activity. Results show that the proportion of women reporting use of condoms remains tremendously low; in both the rural and urban areas. In the urban areas; only 15of women reported having sex with condom during their last intercourse; whereas in the rural areas the proportion is even lower (10). However; multivariate analyses based on the HBM components show that speaking with a partner about how to avoid AIDS (Odds Ratio = 1.63) and perceived benefits of using condoms (Odds Ratio = 1.54) are notable factors that predict condom use. Overall; the study points out that with the exception of perceived severity; the HBM can be applied to understand condom use among the study population. It will be important to emphasise all components of the HBM and empower women with condom negotiation skills