The impact of relationship dynamics on regular condom use in a South African rural community : a case of Vulindlela.

Abstract

Condoms, when used correctly and consistently, are one of the most effective methods to prevent sexually transmitted infections, including HIV; and unplanned pregnancies among sexually active individuals. In South Africa, the male condom is the most freely available and distributed method of contraception, yet young people still engage in risky sexual practices. Condom use is normally determined by considering whether a condom was used during the last sexual encounter. The purpose of this study was to determine which relationships dynamics were associated with consistent condom use within a rural South African setting. A secondary analysis was conducted on data from Project Accept; a randomized control trial. The analysis, with 2596 respondents, took the form of a bivariate Chi-square and multivariate binary logistic regression to determine which factors had an association with regular condom use among all the sampled respondents, the male respondents and the female respondents respectively. The findings of the study showed that among all the sampled respondents and the female respondents respectively, type of relationship, number of sexual encounters, HIV status and occupation were significantly associated with consistent condom use. The other variables included; such as age, sex, level of education, religion, number of sexual partners, age difference and household socioeconomic status did not show an association with consistent condom use among all the sampled respondents and female respondents respectively. Among the male respondents, only the type of relationship and number of sexual encounters were significantly associated with consistent condom use while sex, level of education, occupation, religion, number of sexual partners, HIV status, age difference and household socioeconomic status were not significantly associated with consistent condom use among this group of respondents. These findings show that consistent condom use is impacted by a number of relationship dynamics, and that there is a need to focus on enhancing communication, negotiation and ultimately consistency of condom use among heterosexual couples.