Predictors of Male Condom Use Skills among High-Risk Women in Pretoria, South Africa

Background: When used consistently and correctly, male latex condoms help to prevent the transmission of HIV and other sexually transmitted infections (STIs). However, in order to maximize the effectiveness of this HIV/STI prevention method, condom use skills are essential. This exploratory study examines the performance of South African women who recently traded sex for goods or had unprotected sex on a four-item condom use mastery scale (N = 295). Methods: Bivariate and multivariate analyses were conducted to determine whether age, marital status, education, male condom use at first penetrative sexual experience, receiving prior demonstration of male condom use, and recently trading sex for goods were significant predictors of male condom use skills scores. Results: Participants on average executed only 33.9% of the steps correctly, and almost one-third of the sample was unable to demonstrate any of the steps correctly. Bivariate analyses indicated age, marital status, education, and receiving prior demonstration of male condom use were significantly associated with condom use skills scores (p < .10); these variables were included in multivariate analysis. Whether participants had been shown how to use a male condom previously remained a significant predictor of condom skills in multivariate analysis (p = .046). Conclusion: These findings offer support for on going prevention programs that include a component to improve condom use skills. However, more behavioral skills training is needed for women engaging in sexual risk behaviors because many do not have the skills required to use a male condom properly to protect themselves from HIV/STIs.