Gender, Sexual Self-Efficacy and Consistent Condom use Among Adolescents Living in the HIV Hyper-Endemic Setting of Soweto, South Africa
Closson, K.; Dietrich, J.J.; Lachowsky, N.J.; Nkala, B.; Palmer, A.; Cui, Z.; Chia, J.; Hogg, R.S.; Gray, G.; Miller, C.L.; Kaida, A.
Aids and Behavior 22(2): 671-680
2018
ISSN/ISBN: 1573-3254 PMID: 29090395 DOI: 10.1007/s10461-017-1950-zDocument Number: 676071
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.
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