Abstract
BackgroundHIV/AIDS remains being a disease of great public health concern worldwide. In regions such as sub-Saharan Africa (SSA) where women are disproportionately infected with HIV, women are reportedly less likely capable of negotiating condom use. However, while knowledge of condom use for HIV prevention is extensive among men and women in many countries including Tanzania, evidence is limited about the role of condom negotiation on condom use among women in rural Tanzania.MethodsData originate from a cross-sectional survey of random households conducted in 2011 in Rufiji, Kilombero and Ulanga districts in Tanzania. The survey assessed health-seeking behaviour among women and children using a structured interviewer-administered questionnaire. A total of 2,614 women who were sexually experienced and aged 15-49 years were extracted from the main database for the current analysis. Linkage between condom negotiation and condom use at the last sexual intercourse was assessed using multivariate logistic regression.ResultsPrevalence of condom use at the last sexual intercourse was 22.2% overall, ranging from12.2% among married women to 54.9% among unmarried (single) women. Majority of the women (73.4%) reported being confident to negotiate condom use, and these women were significantly more likely than those who were not confident to have used a condom at the last sexual intercourse (OR = 3.13, 95% CI 2.22-4.41). This effect was controlled for marital status, age, education, religion, number of sexual partners, household wealth and knowledge of HIV prevention by condom use.ConclusionConfidence to negotiate condom use is a significant predictor of actual condom use among women in rural Tanzania. Women, especially unmarried ones, those in multiple partnerships or anyone needing protection should be empowered with condom negotiation skills for increased use of condoms in order to enhance their sexual and reproductive health outcomes.
Highlights
Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) remains being a disease of great public health concern worldwide
Almost three-quarters (74.1%) were married, 7% divorced or widowed and 18.9% were single at the time of the survey
We found that 73.4% of the women reported being confident to negotiate condom use with their sexual partners
Summary
HIV/AIDS remains being a disease of great public health concern worldwide In regions such as sub-Saharan Africa (SSA) where women are disproportionately infected with HIV, women are reportedly less likely capable of negotiating condom use. Research shows that rejection of condom use is due to several reasons including assertions that it reduces sex enjoyment [16], uncomfortable to use, they come off inside a woman [17,18] and that they pedal promiscuity [15] Other barriers such as doubt in the efficacy of condoms, myths, physical side-effects and others have been reported [19]. Condom use tends to be higher in the beginning of a relationship, but drops in subsequent contacts as the relationship extends, even if the HIV status among the partners may be unknown [17]
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