Predictors of Condom Use among Ghanaian Youth: Longitudinal Association

Introduction: Condom use among youth in sub-Saharan Africa, including Ghana remains low despite efforts to promote and improve its use. Consistent use of condoms remains the best way for sexually active youth to protect themselves against HIV and unplanned pregnancies. This study examines the longitudinal association between psychosocial factors and condom use among Ghanaian youth.             

Methods:  A subset of sexually active youth (N = 957) from the Ghana YouthSave surveys were included in this study.  Psychosocial predictors, including constructs from the health belief model, were measured at baseline. Condom use during last sexual intercourse was measured during follow-up survey three years later. Multivariate logistic regression with robust cluster estimator was used to analyze the data.    

Results: Thirty-four percent of youth reported that they or their partner used condoms during last intercourse. In addition to age, health belief model constructs predicted condom use. High level of perceived barriers to condom use decreased the likelihood of using condoms by 8%. Youth who perceived a high level of susceptibility to HIV infection were 21% more likely to use condoms, contrasted with others.   

Discussion: Results are consistent with prior studies that found condom use to be low among Ghanaian youth. Findings also suggest that young people’s beliefs about condoms and HIV influence condom use. Because condom use remains an integral part of HIV prevention, programs for youth should emphasize young people’s susceptibility to HIV and how to overcome barriers to condom use, particularly addressing youth’s harmful beliefs about condoms.