The Measurement of Condom Use in Four Countries in East and Southern Africa
- 205 Downloads
Measurement of condom use is important to assess progress in increasing use. Since 2003, the Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS) have included new measures of self-reported condom use. We use data from Namibia, Swaziland, Tanzania, and Zambia to compare measures of condom use accounting for type of sexual partner. Condom use at last sex ranged from 20% in Tanzania to 57% in Namibia for men, and from 12% in Tanzania to 41% in Namibia for women. Reported condom use was lower in response to questions about condom use every time with last partner (from 13 to 47% for men and from 8 to 33% for women). Condom use was highest among people with two or more partners in the last year and lowest with marital partners. Overall, the prevalence of condom use was low, and there was wide variability across the various measures, countries, sexes, and types of partner. Promotion of condom use in all partnerships, but especially in non-marital relationships and among individuals with multiple partners, remains a critical strategy. New condom use questions in the DHS and AIS expand options for measuring and studying condom use.
KeywordsCondoms/utilization Eastern and Southern Africa Measurement Sexual behavior
We gratefully acknowledge the early input by Svetlana Negroustoueva with ICF International and by Chris Deery to the Tanzania analyses. Thank you to Abby Cannon, Elizabeth Sutherland, and James Thomas for the thoughtful reviews and comments on the manuscript. Funding for this paper was provided by the US Agency for International Development (USAID) through the MEASURE Evaluation project and cooperative agreement GHA-A-00-08-00003-00. The views expressed in this publication do not necessarily reflect the views of USAID or the United States government.
- 1.Joint United Nations Programme on HIV/AIDS (UNAIDS), World Health Organization (WHO). AIDS epidemic update: November 2009. Geneva: UNAIDS; 2009.Google Scholar
- 4.Weller S, Davis-Beaty K. Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev. 2002;1:1–22.Google Scholar
- 13.Bauni EK, Jarabi BO. The low acceptability and use of condoms within marriage: evidence from Nakuru district, Kenya. Afr Popul Stud. 2003;18(1):51–65.Google Scholar
- 15.de Walque D, Kline R. Comparing condom use with different types of partners: evidence from national HIV surveys in Africa [working paper]. Policy Research Working Paper Series 5130. Washington: The World Bank; 2009.Google Scholar
- 20.MEASURE DHS. DHS Model Questionnaire Phase 5 (2008–2013) and DHS Model Questionnaire Phase 6 (2003–2008). Calverton: MEASURE DHS, IFC Macro; ND. Available from http://www.measuredhs.com. Accessed 15 May 2010.
- 21.Ministry of Health and Social Services (MoHSS) [Namibia], Macro International Inc. Namibia demographic and health survey 2006–07. Windhoek/Calverton: MoHSS/Macro International Inc; 2008.Google Scholar
- 22.Central Statistical Office (CSO) [Swaziland], Macro International Inc. Swaziland demographic and health survey 2006–07. Mbabane: Central Statistical Office and Macro International Inc; 2008.Google Scholar
- 23.Tanzania Commission for AIDS (TACAIDS), Zanzibar AIDS Commission (ZAC), National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), Macro International Inc. Tanzania HIV/AIDS and malaria indicator survey 2007–08. Dar es Salaam: TACAIDS, ZAC, NBS, OCGS, and Macro International Inc; 2008.Google Scholar
- 24.Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre (TDRC), University of Zambia, and Macro International Inc. Zambia demographic and health survey 2007. Calverton: CSO and Macro International Inc.; 2009.Google Scholar
- 25.Higher-risk sex, UNAIDS indicator registry [Online database]. Available from http://www.indicatorregistry.org/node/661. Accessed 28 June 2010.
- 26.Condom use during higher-risk sex, UNAIDS indicator registry [Online database]. Available from http://www.indicatorregistry.org/node/662. Accessed 28 June 2010.