Barriers associated with condom use for prevention of HIV infection transimission among adolescents: a case of Senanga urban district of Western Zambia

Abstract

Male latex condoms are 80–95 percent effective in preventing HIV and most STIs when used consistently and correctly. HIV/AIDS is the most dramatic epidemic of the century that has claimed more than 3 million deaths over two decades. Sub-Saharan Africa is heavily affected and accounts for nearly 70 percent of all cases. Despite awareness campaigns, prevention measures and more recently promotion of anti-viral regimens, the prevalence of cases and deaths continues to rise but the prevalence of systematic condom use remains low, especially among adolescents. This study identified barriers to condom use among adolescents based on the Health Belief Model (HBM) in Senanga urban, Western Province. The study was a cross-sectional survey conducted in the first quarter of 2017. Three hundred sixty nine (369) adolescents were interviewed using a structured questionnaire adapted from a standardized WHO/GAP questionnaire. Data were obtained through self-administered questionnaires. Logistic regression analysis was used to identify factors associated with condom use. In spite of satisfactory knowledge on HIV/AIDS transmission, adolescents are still at high risk of contracting the infection. Condom use was declared by only 49.8 percent of males and 45.3 of females. Age, gender and schooling status were associated with condom use. Based on the HBM, failure to use condom was related to its perceived lack of efficacy [OR = 10.1 (2.1–28.7)] and perceived low quality [OR = 1.9 (1.8– 8.9)]. The HBM provides a useful framework for investigating predictors of condom use behaviours among adolescents. This study identifies perceived efficacy (incomplete protective effect) and perceived utilization-related problem (any reported problem using condoms) as the main barriers to condom use. Hence, Future HIV prevention interventions should focus on increasing perceived benefits of condom use, reducing barriers to condoms use, and improving self-efficacy among adolescents. This information will be useful in designing and improving HIV/AIDS prevention outreach programs in the HIV/AIDS hit Western Province of Zambia, Zambia and Sub Saharan Africa at large.