Factors associated with consistent condom use, sexual abstinence, and number of sexual partners among adolescents in Malawi

HIV incidence is high among adolescents in Malawi. This analysis is the first to investigate consistent condom use with multiple sexual encounters and HIV risk perception among adolescents in Malawi. A secondary analysis was performed on a publicly accessible dataset of 4,879 adolescents aged 12-19 years. Odds ratios (OR) and confidence intervals (CI) were ascertained. Adolescents who knew someone with HIV/AIDS (OR=1.84, 95% CI: 1.19-2.84) were more likely to use condoms consistently. Oldest adolescents, ages 18-19 years old, (OR=0.35, 95% CI: 0.16-0.76), 15-17 year olds (OR=0.37, 95% CI: 0.17-0.79), males (OR=0.52, 95% CI: 0.34-0.80,) and those with a primary education (OR=0.62, 95% CI: 0.39-0.99) were less likely to use condoms consistently. Adolescents who perceived themselves to be at no risk (OR=2.34, 95% CI: 1.18-4.64) of contracting HIV were more likely to practice secondary abstinence. Oldest adolescents (OR=0.52, 95% CI: 0.38-0.73) and males (OR=0.50, 95% CI: 0.38-0.65) were less likely to report one partner. Adolescents attending school (OR=1.51, 95% CI: 1.18-1.92) were more likely to report one partner. HIV transmission knowledge, knowing someone who died of AIDS, and rural/urban residence were not associated with consistent condom use or number of sexual partners. Age, gender, knowing someone with HIV/AIDS, HIV risk perception, and school attendance are strongly associated with sexual behavior among adolescents in Malawi. Utilizing these findings, intervention programs can be tailored for this vulnerable group which has been overlooked. Further research should focus on applying age and gender-specific adolescent personal experiences and risk perceptions to change sexual behavior.