3 years ago

Gender, Sexual Self-Efficacy and Consistent Condom Use Among Adolescents Living in the HIV Hyper-Endemic Setting of Soweto, South Africa

Cari L. Miller, Angela Kaida, Janan Janine Dietrich, Kalysha Closson, Jason Chia, Zishan Cui, Glenda Gray, Alexis Palmer, Busi Nkala, Robert S. Hogg, Nathan J. Lachowsky


Within HIV-endemic settings, few studies have examined gendered associations between sexual self-efficacy (SSE), one’s confidence or perceived control over sexual behavior, and uptake of HIV prevention behaviors. Using cross-sectional survey data from 417 sexually-experienced adolescents (aged 14–19, median age = 18, 60% female) in Soweto, South Africa, we measured SSE using a 6-item scale (range:0–6) with ‘high-SSE’ = score > 3 (study alpha = 0.75). Gender-stratified logistic regression models assessed associations between high-SSE and lifetime consistent condom use. A higher proportion of women reported high-SSE (68.7%) than men (49.5%, p < 0.001). We observed no difference in reported consistent condom use by gender (45.5% among women, 45.8% among men; p = 0.943). In confounder models, high-SSE was associated with consistent condom use among men (aOR = 3.51, 95%CI = 1.86–6.64), but not women (aOR = 1.43, 95%CI = 0.74–2.77). Findings highlight that individual-level psychosocial factors are insufficient for understanding condom use and must be considered alongside the relational, social, and structural environments within which young women navigate their sexual lives.

Publisher URL: https://link.springer.com/article/10.1007/s10461-017-1950-z

DOI: 10.1007/s10461-017-1950-z

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