Gender, sexual self-efficacy and consistent condom use among adolescents living in the HIV hyper-endemic setting of Soweto, South Africa
Date
2018
Authors
Closson, Kalysha
Dietrich, Janan Janine
Lachowsky, Nathan
Nkala, Busi
Palmer, Alexis
Cui, Zishan
Chia, Jason
Hogg, Robert S.
Gray, Glenda
Miller, Cari L.
Journal Title
Journal ISSN
Volume Title
Publisher
AIDS and Behavior
Abstract
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.
Description
Keywords
adolescents, HIV prevention, gender, self-efficacy, sexual decision-making, condom use
Citation
Closson, K., Dietrich, J., Lachowsky, N. J., Nkala, B., Palmer, A., Cui, Z., Chia, J., Hogg, R. S., Gray, G., Miller, C. L., & Kaida, A. (2017). Gender, sexual self-efficacy and consistent condom use among adolescents living in the HIV hyper-endemic setting of Soweto, South Africa. AIDS and Behavior, 22(2), 671–680. https://doi.org/10.1007/s10461-017-1950-z