Predictors and Barriers to Condom Use in the African Cohort Study

Tope Analogbei, Nicole Dear*, Domonique Reed, Allahna Esber, Akindiran Akintunde, Emmanuel Bahemana, Yakubu Adamu, Michael Iroezindu, Lucas Maganga, Francis Kiweewa, Jonah Maswai, John Owuoth, Julie A. Ake, Christina S. Polyak, Trevor A. Crowell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Consistent condom use is an inexpensive and efficacious HIV prevention strategy. Understanding factors associated with condom use and barriers to use can inform strategies to increase condom uptake. The ongoing African Cohort Study prospectively enrolls adults at 12 clinical sites in Uganda, Kenya, Tanzania, and Nigeria. At enrollment, participants are asked about condom use at last sex with a regular partner. Robust Poisson regression models were used to evaluate predictors of self-reported condom use. Participants who reported not using condoms were asked to provide reasons. From January 2013 to September 2019, 2482 participants reported having at least one regular sexual partner in the preceding 6 months. Of those, 1577 (63.5%) reported using a condom at last sex. Condom use was more common among older participants, males, HIV-infected participants, and those with an HIV-infected partner. Married participants, those with a partner of unknown HIV status, and those reporting alcohol use were less likely to report condom use at last sex. Condom use at last sex also varied significantly by clinical site. Partner disapproval or refusal to use a condom was a consistent driver of disparities in condom use among participants who were HIV infected, female, and aged 18-24 years. Effective HIV prevention programs should integrate condom education with the tools necessary to negotiate condom use with regular partners.

Original languageEnglish
Pages (from-to)228-236
Number of pages9
JournalAIDS Patient Care and STDs
Issue number5
StatePublished - 1 May 2020
Externally publishedYes


  • Africa
  • HIV
  • condom
  • prevention
  • regular partner


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