Gender and relationship differences in condom use among 15-24-year-olds in Angola

Abstract

Context: The sexual behavior of young people in Angola will play a major role in the future spread of HIV, yet few young people use condoms consistently, and reported rates of condom use are low. It is important to identify determinants of condom use among Angolan adolescents and young adults. Methods: Data for analysis came from 1,995 sexually experienced youth aged 15-24 who participated in a 2001 knowledge, attitudes and practices survey in Luanda, Angola. Logistic regression analysis was performed to identify predictors of consistent condom use by gender and determinants of condom use at last intercourse by type of relationship. Results: For both males and females, consistent condom use was positively associated with higher levels of education (odds ratios, 1.7-2.6) and believing that condoms did not diminish sexual pleasure (1.8 for both genders). It was negatively associated with being married or in a cohabiting relationship (0.1-0.5). Females who equated condom use with lack of trust were less likely to use condoms consistently (0.5), and males who believed that condoms were safe and those who had multiple partners were more likely to be consistent users (1.6 and 1.7, respectively). Urban residence, higher education, being in school and not equating condom use with lack of trust were important predictors of use at last intercourse in regular and casual relationships, whereas access to condoms was the most important factor in spousal relationships (4.5). Conclusions: Intervention programs aimed at less educated, periurban and unemployed young people should be part of an effective HIV-prevention strategy. Such programs must address misperceptions among youth about condom use and the need for protection from HIV and other STIs.