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Open Access Research article

Correlates of consistent condom use among recently initiated and traditionally circumcised men in the rural areas of the Eastern Cape Province, South Africa

Anam Nyembezi1*, Robert AC Ruiter2, Bart van den Borne3, Sibusiso Sifunda4, Itumeleng Funani5 and Priscilla Reddy1

Author Affiliations

1 Population Health, Health Systems and Innovation, Human Sciences Research Council, Private Bag X9182, Cape Town 8000, South Africa

2 Department of Work & Social Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands

3 Department of Health Education & Health Promotion, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands

4 HIV/AIDS, STIs and TB, Human Sciences Research Council, Private Bag X9182, Cape Town 8000, South Africa

5 Medical Research Council, Health Promotion Research & Development Unit, PO Box 19070, Tygerberg 7505, South Africa

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BMC Public Health 2014, 14:668  doi:10.1186/1471-2458-14-668

Published: 30 June 2014

Abstract

Background

Consistent use of condoms is the most effective method of preventing STIs including HIV. However, recent evidence suggests that limited knowledge about HIV prevention benefits from male circumcision leads to inconsistent condom use among traditionally circumcised men. The aim of this paper is to report on the prevalence of consistent condom use and identify its psychosocial correlates to inform future HIV prevention strategies among traditionally circumcised men in rural areas of the Eastern Cape Province of South Africa.

Methods

A cross-sectional study using interviewer administered fully structured questionnaires was conducted among 1656 men who had undergone initiation and traditional male circumcision in rural areas of the Eastern Cape Province of South Africa. Logistic regression was used to evaluate univariate and multivariate relationships of psychosocial correlates with consistent condom use.

Results

The mean age of the participants was 21.4 years. About 45% belonged to the amaXhosa ethnic group, followed by 15.1% of the amaMpondo, 11.6% of the amaHlubi, and 27.9% from other ethnic groups. A total of 72.3% reported having a main sexual partner and of those 44.8% indicated having other sexual partners as well. About 49% reported consistent condom use and 80% used free government issued condoms, varies among ethnic groups. A total of 35.1% indicated having tested for HIV. Of those who tested for HIV, 46% reported inconsistent condom use when having sex with their sexual partners. Univariate and multivariate analyses showed a positive association between consistent condom use and the general knowledge of condom use, attitude towards condom use with main and casual sexual partners, subjective norm towards condom use with the main sexual partner, perceived self-efficacy towards condom use, positive self-esteem, beliefs about traditional male circumcision and STI protection, attitude towards gender based violence, and cultural alienation.

Conclusions

The study findings reveal important target points for future cultural sensitive health education aimed at increasing consistent condom use among initiated and traditionally circumcised men in the Eastern Cape Province.

Keywords:
Consistent condom use; Traditional male initiation and circumcision; STI/HIV intervention; Rural areas; Eastern Cape Province of South Africa