Factors associated with condom use among men and women living with HIV in Lilongwe, Malawi: a cross-sectional study

Lisa B Haddad; Jennifer H Tang; Jamie Krashin; Wingston Ng’ambi; Hannock Tweya; Bernadette Samala; Jane Chiwoko; Thomas Chaweza; Mina C Hosseinipour; Eva Lathrop; Denise J Jamieson; Sam Phiri

doi:10.1136/bmjsrh-2017-101825

Back

Factors associated with condom use among men and women living with HIV in Lilongwe, Malawi: a cross-sectional study

Journal article

Open access

Peer reviewed

Factors associated with condom use among men and women living with HIV in Lilongwe, Malawi: a cross-sectional study

Lisa B Haddad, Jennifer H Tang, Jamie Krashin, Wingston Ng’ambi, Hannock Tweya, Bernadette Samala, Jane Chiwoko, Thomas Chaweza, Mina C Hosseinipour, Eva Lathrop, …

BMJ sexual & reproductive health, Vol.44(1), pp.1-53

01/01/2018

DOI: 10.1136/bmjsrh-2017-101825

PMCID: PMC6283329

PMID: 29248899

Files and links (1)

url

https://doi.org/10.1136/bmjsrh-2017-101825View

Published (Version of record) Open Access

Abstract

BackgroundUnderstanding the influences on condom use among men and women living with HIV is critical to tailoring sexually transmitted infection/HIV prevention efforts.MethodsThis is a sub-analysis of a cross-sectional survey including 255 women and 220 men who were sexually active, HIV-positive, and attending HIV care visits in Lilongwe, Malawi. We estimated adjusted prevalence ratios (aPRs) to evaluate for factors associated with consistent condom use (always using condoms in the past month) and use at last coitus for men and women in separate models.ResultsAmong women: 38% and 55% reported consistent condom use and condom use at last coitus, respectively. For women, consistent use and use at last coitus were positively associated with the ability to refuse sex without condoms and shared decision-making compared with making the decision alone regarding condom use, and negatively associated with desire for children in the future. Consistent use also increased with longer antiretroviral therapy (ART) use (≥1 year compared with no ART use). Among men: 51% and 69% reported consistent condom use and condom use at last coitus, respectively. For men, the ability to refuse sex without condoms was associated with consistent use and use at last coitus, and believing that condoms should be used with other contraception was associated with consistent use.ConclusionsOur findings demonstrate ongoing low condom utilisation among HIV-positive individuals, and highlight that ART and contraceptive use do not deter condom use. Efforts to increase condom utilisation must recognise individual-level factors that influence use and should focus on relationship dynamics and promotion of empowerment and self-efficacy.

Details

Title: Subtitle: Factors associated with condom use among men and women living with HIV in Lilongwe, Malawi: a cross-sectional study
Creators: Lisa B Haddad - Emory University
Jennifer H Tang - Kamuzu Central Hospital
Jamie Krashin - University of North Carolina at Chapel Hill
Wingston Ng’ambi - Kamuzu Central Hospital
Hannock Tweya - Lighthouse Trust
Bernadette Samala - Lighthouse Trust
Jane Chiwoko - Lighthouse Trust
Thomas Chaweza - Kamuzu Central Hospital
Mina C Hosseinipour - Kamuzu Central Hospital
Eva Lathrop - Emory University
Denise J Jamieson - Emory University
Sam Phiri - Lighthouse Trust
Resource Type: Journal article
Publication Details: BMJ sexual & reproductive health, Vol.44(1), pp.1-53
DOI: 10.1136/bmjsrh-2017-101825
PMID: 29248899
PMCID: PMC6283329
NLM abbreviation: BMJ Sex Reprod Health
ISSN: 2515-1991
eISSN: 2515-2009
Grant note: DOI: 10.13039/100012297, name: Society of Family Planning
Language: English
Date published: 01/01/2018
Academic Unit: Obstetrics and Gynecology; VPMA - Administration
Record Identifier: 9984446273502771

Metrics

4 Record Views

16 Times Cited - Web of Science