Volume 147, Issue 2 p. 258-267
CLINICAL ARTICLE

Exploring gender and partner communication: Theory of planned behavior predictors for condom use among urban youth in Zambia

Rachna Nag Chowdhuri

Corresponding Author

Rachna Nag Chowdhuri

Innovations for Poverty Action, Lusaka, Zambia

Correspondence

Rachna Nag Chowdhuri, 26 Mwambula Street, Jesmondine, Lusaka, Zambia.

Email: [email protected]

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Jessie Pinchoff

Jessie Pinchoff

Poverty, Gender and Youth, Population Council, New York, NY, USA

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Christopher B. Boyer

Christopher B. Boyer

Innovations for Poverty Action, New Haven, CT, USA

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Thoai D. Ngo

Thoai D. Ngo

Poverty, Gender and Youth, Population Council, New York, NY, USA

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First published: 31 August 2019
Citations: 3

Abstract

Objective

To understand how knowledge and perceptions of condoms and partner communication influence use of condoms in a high HIV prevalence setting and gender-specific differences.

Methods

A cross-sectional study was conducted in Zambia from 2015 to 2016. The survey included questions on demographics, sexual behavior, contraceptive perceptions, and behaviors. We constructed multivariate regression models using the Theory of Planned Behavior to determine associations between knowledge, perceptions, and perceived control with intended, communicated, and reported use of condoms by gender.

Results

The participants were 2388 sexually active urban residents aged 18–24 years. In the sample, 1646 (69%) were female, 841 (35%) married, and 1894 (61%) unemployed. Partner communication was the predictor most associated with use of condoms. Among women, partner communication was associated with over three times higher odds of condom use (odds ratio [OR] 3.51, 95% confidence interval [CI] 2.65–4.65) but being married reduced the odds of condom use by 76% (OR 0.24, 95% CI 0.17–0.33). For men, a network of friends that was supportive of the use of contraception was associated with increased odds of 55% for use of condoms (OR 1.55, 95% CI 1.10–2.18).

Conclusion

Public health programs aimed at increasing safer sexual behavior and use of condoms must consider improving gender equity and partner communication, as knowledge of contraceptives and positive perceptions are not enough to ensure their use.

CONFLICTS OF INTEREST

The authors have no conflicts of interest.