Factors predicting condom use amoung sexually active adolescents in rural Malawi

Background: Condom use offers the best protection against HIV infection for sexually active youth, but youth seldom use condoms in high prevalence countries like Malawi.

Objective: To assess predictors of condom use among sexually active adolescents in rural communities of Malawi.

Methods: This analysis used data from the baseline interview of an intervention study for 153 sexually active youth ages 13-19. We examined demographic factors, condom attitude (10 items, scored % positive, a=.81, mean =56.2), condom use self-efficacy (single item, “how confident are you that you know how to use a condom correctly -not confident, 49.0%, somewhat confident, 13.8%, very confident, 36.8%), and partner communication (2-item index if talked in the last 2 months about safer sex and/or using condoms, # discussed, range 0-2, α=.90, mean=1.39).

Results: In the last 2 months, 37.1% of the sexually active youth said that they had used a condom at least sometimes. Condom use was significantly related to condom attitudes (r=.287), condom use self-efficacy (r=.524), partner communication (r=.509), and education greater than 5 years (r=.244). However, condom use among sexually active youth was not significantly correlated with age, gender, or whether currently in school. In a logistic regression with all significantly correlated variables, the only significant predictors were confidence in using condoms (Odds Ratio 2.71, CI 1.61-4.57) and partner communication (Odds Ratio 2.21, CI 1.47-3.32).

Discussion: Condom use self-efficacy and partner communication related to condom use and they should be integrated into HIV prevention interventions for sexually active youth in Malawi.