An examination of barriers to condom use among ghanaians

Introduction: Ghana has a relatively low and stable HIV prevalence rate of 1.5%. However in-country variation in infection prevalence dictate need to explore condom use barriers; an impediment to lowering HIV transmission. This study explores the relationship between perceived condom use barriers and condom use among Ghanaians.

Methods: Data from 3,517 sexually active individuals from the Condom Barrier Scale (CBS) were analyzed. Exploratory factor analysis (EFA) was employed to identify latent-factors among 29 items. Standardized factor scores were used to create categorical variables based on tertiles for each factor. Binary logistic regression predicted condom use based on latent-factors.

Results: Thirteen items were removed via series of EFAs leaving 16 items and subsequent extraction of three latent factors; partner barrier (PB), effect on sexual experience (ESE) and motivational barriers (MB). Participants in higher tertiles of PB were more likely to report condom use compared to 1st tertile (OR= 1.31, CI 1.05-1.64, for 2nd tertile; and OR= 2.50, CI 1.96-3.13, for 3rd tertile). MB-participants in higher tertiles were more likely to report condom use compared to 1st tertile (OR= 1.51, CI 1.21-1.89, for 2nd tertile; and OR= 4.10, CI 3.24-5.19, for 3rd tertile). For ESE, participants in higher tertiles were less likely to report condom use compared to 1st tertile (OR= .57, CI.46-.70, for 2nd tertile; and OR= .57, CI .46-.71, for 3rd tertile).

Discussion: Partner barriers, effect on sex, and motivational barriers are significant constructs to consider as part of interventions to reduce condom use barriers among Ghanaians.