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Predictors and Barriers to Condom Use in the African Cohort Study

2020; Mary Ann Liebert, Inc.; Volume: 34; Issue: 5 Linguagem: Inglês

10.1089/apc.2019.0302

1557-7449

Tope Analogbei, Nicole Dear, Domonique Reed, Allahna Esber, Akindiran Akintunde, Emmanuel Bahemana, Yakubu Adamu, Michael Iroezindu, Lucas Maganga, Francis Kiweewa, Jonah Maswai, John Owuoth, Julie A. Ake, Christina S. Polyak, Trevor A. Crowell, O. Falodun, Kevin Song, M. Milazzo, Shauna Mankiewicz, Susanne Schech, Alexandra Golway, Tsedal Mebrahtu, Eunjung Lee, Kimberly Bohince, Tiffany E. Hamm, Aarushi K. Parikh, J. Hern, K. Lombardi, Michelle Imbach, Leigh Anne Eller, Sheila A. Peel, Jennifer Malia, Arne Kroidl, Inge Kroidl, Christof Geldmacher, Cate Kafeero, A Nambuya, Josephine Tegamanyi, Harriet Birungi, Olive Mugagga, G. Nassali, Paul Wangiri, M. Nantabo, P. Nambulondo, Brenda Atwijuka, Allen Asiimwe, Christine Nabanoba, Michael Semwogerere, Robert Mwesigwa, S. Jjuuko, Rosemary Namagembe, E. Bagyendagye, Allan Tindikahwa, Ivan Rwomushana, F. Ssentongo, Hannah Kibuuka, Monica Millard, Joan Kapkiai, Salome Wangare, R. Mangesoi, Philemon C Chepkwony, L. Bor, E. Maera, Alex Kasembeli, J. Rotich, Carolyne Kipkoech, Winnie Chepkemoi, Agnes J Rono, Zeddy Bett Kesi, Janet Ngeno, Edwin Langat, Keneddy Labosso, Ken Langat, Robert Kirui, Linner Rotich, M. Mabwai, Ella Chelangat, Jeam Otieno Agutu, C. Tonui, Enock Changwony, Mike Bii, Ezekiel Chumba, Julius Korir, Janet Sugut, Danson Gitonga, Robert Ngetich, Samuel Kiprotich, Winnie Rehema, Celine Ogari, Irene A Ouma, Ochieng Adimo, С. Огай, Charles Okwaro, Elias K. Maranga, J. Ochola, Kennedy Obambo, Valentine Sing’oei, L. H. Otieno, O. Nyapiedho, Nicolette G.C. van der Sande, Elizabeth A. Odemba, F. Wanjiru, Samoel Khamadi, Evarist Chiweka, Anange Lwilla, Dorothy Mkondoo, Nancy Somi, Paschal Kiliba, Mtasi Mwaipopo, Gwamaka Mwaisanga, Joshua Muhumuza, N. Mkingule, O. Mwasulama, A. Sanagare, Peter Kishimbo, Gloria L. David, Faraja Mbwayu, Jaquiline Mwamwaja, Janeth Likiliwike, Joshua Muhumuza, Ruby Mcharo, N. Mkingule, O. Mwasulama, Bariki Mtafya, Cornelia Lueer, Abisai Kisinda, T. Mbena, Hawa Mfumbulwa, Laban Mwandumbya, Peter Edwin, Willyhelmina Olomi, Yakubu Adamu, Adeyinka Oye Akintunde, Abdulwasiu Bolaji Tiamiyu, Afoke Kokogho, Sulma I. Mohammed, Nkechinyere Elizabeth Harrison, Uzoamaka Concilia Agbaim, O.A. Adegbite, Zahra Parker, Gabriela Adelakun, Folake Oni, R.O Ndbuisi, Jacintal Elemere, Nnamdi Azuakola, Thomas Williams, Malachy Emeka Ayogu, Onome Enas, O. Enameguono, Ariake Odo, I.C. Ukaegbu, Oscar Ugwuezumba, Samson Olalekan Odeyemi, Ndubuisis Okeke, L Umeji, Alessandra De Rose, Hanna Daniel, H. Nwando, E.I. Nicholas, Temiloluwa Ololade Iyanda, C A Okolo, V.Y. Mene, Banenat B. Dogonyaro, O. Olabulo, O. Akinseli, F. Onukun, Gregor Knopp,

HIV, Drug Use, Sexual Risk

Consistent condom use is an inexpensive and efficacious HIV prevention strategy. Understanding factors associated with condom use and barriers to use can inform strategies to increase condom uptake. The ongoing African Cohort Study prospectively enrolls adults at 12 clinical sites in Uganda, Kenya, Tanzania, and Nigeria. At enrollment, participants are asked about condom use at last sex with a regular partner. Robust Poisson regression models were used to evaluate predictors of self-reported condom use. Participants who reported not using condoms were asked to provide reasons. From January 2013 to September 2019, 2482 participants reported having at least one regular sexual partner in the preceding 6 months. Of those, 1577 (63.5%) reported using a condom at last sex. Condom use was more common among older participants, males, HIV-infected participants, and those with an HIV-infected partner. Married participants, those with a partner of unknown HIV status, and those reporting alcohol use were less likely to report condom use at last sex. Condom use at last sex also varied significantly by clinical site. Partner disapproval or refusal to use a condom was a consistent driver of disparities in condom use among participants who were HIV infected, female, and aged 18–24 years. Effective HIV prevention programs should integrate condom education with the tools necessary to negotiate condom use with regular partners.