Correlates of Male Condom Use Skills among High-Risk Women in South Africa

Abstract

This exploratory study examined the performance of 295 South African women—who recently traded sex for goods or had unprotected sex—on a male condom use mastery index. Bivariate and multivariate logistic regression analyses were conducted to determine whether age, marital status, highest education obtained, male condom use at first penetrative sex, receiving prior demonstration of male condom use, recent sexually transmitted infection symptoms, and recently trading sex were significantly associated with index scores. Adjusted odds ratios indicated that age and sexually transmitted infection symptoms were negatively associated with condom skills; women who were older and had a higher number of recent sexually transmitted infection symptoms were more likely to have lower scores. Furthermore, participants executed, on average, approximately one third of condom use steps correctly. These findings suggest a need for increased behavioral skills training for women engaging in sexual risk behaviors because many lack the skills required to use a male condom properly.

Acknowledgments

RTI International is a trade name of Research Triangle Institute. The research described in this article was conducted with support from the National Institute on Alcohol Abuse and Alcoholism (NIAAA; R01 AA014488; principal investigator, Wendee M. Wechsberg). The interpretations and conclusions do not necessarily represent the position of the NIAAA or the U.S. Department of Health and Human Services. Some of the preliminary research and findings appeared in Felicia A. Browne's master's thesis (“Predictors of Condom Use Skills Among High-Risk Women in Pretoria, South Africa”; Gillings School of Global Public Health, University of North Carolina, 2007). We gratefully acknowledge the Pretoria field staff for collecting the data, Judit Albert and Virginia Niehaus for their assistance with data entry and verification, Drs. Dorothy Browne and William Zule for their comments and feedback, Dr. Bronwyn Myers for her input regarding variable categories, and Jeff Novey for his editing.

Notes

Note. N = 295.

Note. N = 295.

Note. OR = odds ratio; CI = confidence interval; ref = reference.

^a The upper limit is 1.00 because the original number (0.995) was rounded to two decimal places, as were all the numbers in this table.

*p < .10. **p < .05.