Putting the C back into the ABCs: a multi-year, multi-region investigation of condom use by Ugandan youths 2003-2010

PLoS One. 2014 Apr 4;9(4):e93083. doi: 10.1371/journal.pone.0093083. eCollection 2014.

Abstract

A major strategy for preventing transmission of HIV and other STIs is the consistent use of condoms during sexual intercourse. Condom use among youths is particularly important to reduce the number of new cases and the national prevalence. Condom use has been often promoted by the Uganda National AIDS Commission. Although a number of studies have established an association between condom use at one's sexual debut and future condom use, few studies have explored this association over time, and whether the results are generalizable across multiple locations. This multi time point, multi district study assesses the relationship between sexual debut and condom use and consistent use of condoms thereafter. Uganda has used Lot Quality Assurance Sampling surveys since 2003 to monitor district level HIV programs and improve access to HIV health services. This study includes 4518 sexually active youths interviewed at five time points (2003-2010) in up to 23 districts located across Uganda. Using logistic regression, we measured the association of condom use at first sexual intercourse on recent condom usage, controlling for several factors including: age, sex, education, marital status, age at first intercourse, geographical location, and survey year. The odds of condom use at last intercourse, using a condom at last intercourse with a non-regular partner, and consistently using a condom are, respectively, 9.63 (95%WaldCI = 8.03-11.56), 3.48 (95%WaldCI = 2.27-5.33), and 11.12 (95%WaldCI = 8.95-13.81) times more likely for those individuals using condoms during their sexual debut. These values did not decrease by more than 20% when controlling for potential confounders. The results suggest that HIV prevention programs should encourage condom use among youth during sexual debut. Success with this outcome may have a lasting influence on preventing HIV and other STIs later in life.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Condoms / statistics & numerical data*
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV-1
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Safe Sex / statistics & numerical data
  • Sexually Transmitted Diseases / epidemiology
  • Sexually Transmitted Diseases / prevention & control*
  • Uganda / epidemiology
  • Young Adult

Grants and funding

This study is made possible by the generous support of the American people through the United States Agency for International Development (USAID) through Sub-award Number: 617-A-00-09-00006-00-LATH. The contents are the responsibility of the Liverpool School of Tropical Medicine and Management Science for Health and do not necessarily reflect the views of USAID or the United States Government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.