Open Access Highly Accessed Research article

Role of condom negotiation on condom use among women of reproductive age in three districts in Tanzania

Amon Exavery1*, Almamy M Kanté12, Elizabeth Jackson2, John Noronha1, Gloria Sikustahili1, Kassimu Tani1, Hildegalda P Mushi1, Colin Baynes12, Kate Ramsey12, Ahmed Hingora1 and James F Phillips12

Author Affiliations

1 Ifakara Health Institute (IHI), Dar es Salaam, Tanzania

2 Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, Columbia, USA

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BMC Public Health 2012, 12:1097  doi:10.1186/1471-2458-12-1097

Published: 20 December 2012



HIV/AIDS remains being a disease of great public health concern worldwide. In regions such as sub-Saharan Africa (SSA) where women are disproportionately infected with HIV, women are reportedly less likely capable of negotiating condom use. However, while knowledge of condom use for HIV prevention is extensive among men and women in many countries including Tanzania, evidence is limited about the role of condom negotiation on condom use among women in rural Tanzania.


Data originate from a cross-sectional survey of random households conducted in 2011 in Rufiji, Kilombero and Ulanga districts in Tanzania. The survey assessed health-seeking behaviour among women and children using a structured interviewer-administered questionnaire. A total of 2,614 women who were sexually experienced and aged 15-49 years were extracted from the main database for the current analysis. Linkage between condom negotiation and condom use at the last sexual intercourse was assessed using multivariate logistic regression.


Prevalence of condom use at the last sexual intercourse was 22.2% overall, ranging from12.2% among married women to 54.9% among unmarried (single) women. Majority of the women (73.4%) reported being confident to negotiate condom use, and these women were significantly more likely than those who were not confident to have used a condom at the last sexual intercourse (OR = 3.13, 95% CI 2.22-4.41). This effect was controlled for marital status, age, education, religion, number of sexual partners, household wealth and knowledge of HIV prevention by condom use.


Confidence to negotiate condom use is a significant predictor of actual condom use among women in rural Tanzania. Women, especially unmarried ones, those in multiple partnerships or anyone needing protection should be empowered with condom negotiation skills for increased use of condoms in order to enhance their sexual and reproductive health outcomes.

Condom negotiation; Condom use; Women; Rural Tanzania