Skip to main content

Advertisement

SpringerLink
Log in

The Measurement of Condom Use in Four Countries in East and Southern Africa

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Measurement of condom use is important to assess progress in increasing use. Since 2003, the Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS) have included new measures of self-reported condom use. We use data from Namibia, Swaziland, Tanzania, and Zambia to compare measures of condom use accounting for type of sexual partner. Condom use at last sex ranged from 20% in Tanzania to 57% in Namibia for men, and from 12% in Tanzania to 41% in Namibia for women. Reported condom use was lower in response to questions about condom use every time with last partner (from 13 to 47% for men and from 8 to 33% for women). Condom use was highest among people with two or more partners in the last year and lowest with marital partners. Overall, the prevalence of condom use was low, and there was wide variability across the various measures, countries, sexes, and types of partner. Promotion of condom use in all partnerships, but especially in non-marital relationships and among individuals with multiple partners, remains a critical strategy. New condom use questions in the DHS and AIS expand options for measuring and studying condom use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Joint United Nations Programme on HIV/AIDS (UNAIDS), World Health Organization (WHO). AIDS epidemic update: November 2009. Geneva: UNAIDS; 2009.

    Google Scholar 

  2. Hearst N, Chen S. Condom promotion for AIDS prevention in the developing world: is it working? Stud Fam Plan. 2004;35(1):39–47.

    Article  Google Scholar 

  3. Pinkerton SD, Abramson PR. Effectiveness of condoms in preventing HIV transmission. Soc Sci Med. 1997;44(9):1303–12.

    Article  PubMed  CAS  Google Scholar 

  4. Weller S, Davis-Beaty K. Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev. 2002;1:1–22.

    Google Scholar 

  5. Ahmed S, Lutalo T, Wawer M, Serwadda D, Sewankambo NK, Nalugoda F, et al. HIV incidence and sexually transmitted disease prevalence associated with condom use: a population study in Rakai, Uganda. AIDS. 2001;15(16):2171–9.

    Article  PubMed  CAS  Google Scholar 

  6. Olley B, Seedat S, Gxamza F, Reuter H, Stein D. Determinants of unprotected sex among HIV-positive patients in South Africa. AIDS Care. 2005;17(1):1–9.

    Article  PubMed  CAS  Google Scholar 

  7. Bunnell R, Opio A, Musinguzi J, Kirungi W, Ekwaru P, Mishra V, et al. HIV transmission risk behavior among HIV-infected adults in Uganda: results of a nationally representative survey. AIDS. 2008;22(5):617–24.

    Article  PubMed  Google Scholar 

  8. Fylkesnes K, Musonda RM, Sichone M, Ndhlovu Z, Tembo F, Monze M. Declining HIV prevalence and risk behaviours in Zambia: evidence from surveillance and population-based surveys. AIDS. 2001;15(7):907–16.

    Article  PubMed  CAS  Google Scholar 

  9. Boerma JT, Weir SS. Integrating demographic and epidemiological approaches to research on HIV/AIDS: the proximate-determinants framework. J Infect Dis. 2005;191(Suppl 1):S61–7.

    Article  PubMed  Google Scholar 

  10. Chimbiri AM. The condom is an ‘intruder’ in marriage: evidence from rural Malawi. Soc Sci Med. 2007;64(5):1102–15.

    Article  PubMed  Google Scholar 

  11. Hendriksen ES, Pettifor A, Lee SJ, Coates TJ, Rees HV. Predictors of condom use among young adults in South Africa: the reproductive health and HIV research unit national youth survey. AJPH. 2007;97(7):1241–8.

    Article  Google Scholar 

  12. Maharaj P, Cleland J. Condom use within marital and cohabiting partnerships in KwaZulu Natal, South Africa. Stud Fam Plan. 2004;35(2):116–24.

    Article  Google Scholar 

  13. Bauni EK, Jarabi BO. The low acceptability and use of condoms within marriage: evidence from Nakuru district, Kenya. Afr Popul Stud. 2003;18(1):51–65.

    Google Scholar 

  14. Biraro S, Shafer L, Kleinschmidt I, Wolff B, Karabalinde A, Nalwoga A, et al. Is sexual risk taking behaviour changing in rural south-west Uganda? Behaviour trends in a rural population cohort 1993–2006. Sex Transm Infect. 2009;85(Suppl 1):i3–11.

    Article  PubMed  Google Scholar 

  15. de Walque D, Kline R. Comparing condom use with different types of partners: evidence from national HIV surveys in Africa [working paper]. Policy Research Working Paper Series 5130. Washington: The World Bank; 2009.

  16. Noar SM, Cole C, Carlyle K. Condom use measurement in 56 studies of sexual risk behavior: review and recommendations. Arch Sex Behav. 2006;35(3):327–45.

    Article  PubMed  Google Scholar 

  17. Curtis SL, Sutherland EG. Measuring sexual behavior in the era of HIV/AIDS: the experience of demographic and health surveys and similar enquiries. Sex Transm Infect. 2004;80:ii22–7.

    Article  PubMed  Google Scholar 

  18. Sheeran P, Abraham C. Measurement of condom use in 72 studies of HIV-preventive behavior: a critical review. Patient Educ Couns. 1994;24:199–216.

    Article  PubMed  CAS  Google Scholar 

  19. Minnis AM, van der Sraten A, Gerdts C, Padian NS. A comparison of four condom-use measures in predicting pregnancy, cervical STI and HIV incidence among Zimbabwean women. Sex Transm Infect. 2010;86:231–5.

    Article  PubMed  Google Scholar 

  20. MEASURE DHS. DHS Model Questionnaire Phase 5 (2008–2013) and DHS Model Questionnaire Phase 6 (2003–2008). Calverton: MEASURE DHS, IFC Macro; ND. Available from http://www.measuredhs.com. Accessed 15 May 2010.

  21. Ministry of Health and Social Services (MoHSS) [Namibia], Macro International Inc. Namibia demographic and health survey 2006–07. Windhoek/Calverton: MoHSS/Macro International Inc; 2008.

    Google Scholar 

  22. Central Statistical Office (CSO) [Swaziland], Macro International Inc. Swaziland demographic and health survey 2006–07. Mbabane: Central Statistical Office and Macro International Inc; 2008.

    Google Scholar 

  23. Tanzania Commission for AIDS (TACAIDS), Zanzibar AIDS Commission (ZAC), National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), Macro International Inc. Tanzania HIV/AIDS and malaria indicator survey 2007–08. Dar es Salaam: TACAIDS, ZAC, NBS, OCGS, and Macro International Inc; 2008.

    Google Scholar 

  24. Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre (TDRC), University of Zambia, and Macro International Inc. Zambia demographic and health survey 2007. Calverton: CSO and Macro International Inc.; 2009.

  25. Higher-risk sex, UNAIDS indicator registry [Online database]. Available from http://www.indicatorregistry.org/node/661. Accessed 28 June 2010.

  26. Condom use during higher-risk sex, UNAIDS indicator registry [Online database]. Available from http://www.indicatorregistry.org/node/662. Accessed 28 June 2010.

Download references

Acknowledgments

We gratefully acknowledge the early input by Svetlana Negroustoueva with ICF International and by Chris Deery to the Tanzania analyses. Thank you to Abby Cannon, Elizabeth Sutherland, and James Thomas for the thoughtful reviews and comments on the manuscript. Funding for this paper was provided by the US Agency for International Development (USAID) through the MEASURE Evaluation project and cooperative agreement GHA-A-00-08-00003-00. The views expressed in this publication do not necessarily reflect the views of USAID or the United States government.

Author information

Author notes

  1. Winnie K. Luseno

    Present address: Pacific Institute for Research and Evaluation (PIRE), Chapel Hill Center, 1516 E. Franklin Street, Suite 200, Chapel Hill, NC, 27514-2812, USA

Authors and Affiliations

  1. MEASURE Evaluation Project, Carolina Population Center, University of North Carolina at Chapel Hill, 206 W. Franklin Street, 2nd Floor, CB#8120, Chapel Hill, NC, USA

    Heidi W. Reynolds, Winnie K. Luseno & Ilene S. Speizer

  2. Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Winnie K. Luseno & Ilene S. Speizer

Authors
  1. Heidi W. Reynolds
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Winnie K. Luseno
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ilene S. Speizer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Heidi W. Reynolds.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reynolds, H.W., Luseno, W.K. & Speizer, I.S. The Measurement of Condom Use in Four Countries in East and Southern Africa. AIDS Behav 16, 1044–1053 (2012). https://doi.org/10.1007/s10461-012-0146-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-012-0146-9

Keywords

Search

Navigation