205830 Worms, condom effectiveness and self-efficacy: Condom beliefs and other determinants of willingness to use condoms among a seminomadic tribe in East Africa

Monday, November 9, 2009

Aaron J. Siegler, MHS , Rollins School of Public Health, Emory University, Atlanta, GA
Jessie Mbwambo, MD , Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
Ralph J. DiClemente, PhD , Rollins School of Public Health and Center for AIDS Research, Emory Univeristy, Atlanta, GA
Background: Condom use is effective in preventing HIV transmission, and condom promotion is an integral part of HIV prevention models worldwide. Researchers in Tanzania, South Africa, and Namibia have found rumors that negatively reflect on condoms, such as the belief that condoms contain worms.

Methods: Study data comes from a cross sectional cluster-randomized survey (n=370) representing adults from the Maasai tribe in two rural districts in Northern Tanzania. A series of in-depth and cognitive interviews informed development of survey items. The survey had a response rate of 91%, and analyses are conducted with probability weighting to account for complex sampling and survey design factors.

Results: In univariate analyses many respondents subscribe to negative rumors about condoms, and rumor belief was associated with decreased willingness to use condoms. A majority agree with statements that condoms contain worms (53%), condoms have holes (56%) and condoms cause HIV (53%). The multivariate logistic regression model assessing willingness to use condoms observed that positive beliefs in condom effectiveness (condoms work successfully OR=14.04) are associated with willingness to use condoms, while rumor beliefs (condoms have worms OR=0.07) are negatively associated with willingness to use condoms.

Conclusions: Future condom promotion interventions should consider reinforcing beliefs in condom effectiveness as well as addressing negative rumors surrounding condoms. Further research needs to be undertaken to determine the association between these factors and condom use in areas where use of condoms is more prevalent.

Learning Objectives:
1. List five rumors from Tanzania regarding condoms. 2. Articulate how rumors negatively impact willingness to use condoms.

Keywords: Condom Use, Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I completed my MHS in International Public Health at Johns Hopkins University in 2005. This work is the topic of my dissertation at Emory University, funded by a NIH National Research Service Award. Research findings stem from 9 months of fieldwork in Tanzania, working with local collaborators at Muhimbili University. I am responsible for the research design, implementation and analysis presented in this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.