To reduce the prevalence of reproductive health problems among adolescents, governmental and nongovernmental organizations in Cameroon are implementing youth-oriented reproductive health programs. To facilitate the design of effective programs to increase condom use, this study examines survey data on the determinants of having ever used condoms and on current condom use with regular and casual partners among unmarried young people in urban Cameroon. While most adolescents have tried condoms at least once, use remains inconsistent. Parental support, personal risk perception, and self-efficacy are found to be associated with higher levels of condom use. Youth-oriented programs seeking to increase the number of new condom users among the young should promote parental support for condom use and enhance young people's perceptions of personal risk. Programs that work to convince the young that their sexual history can put them at risk of HIV infection and that dispel the myth that HIV risk with regular partners is low may serve to increase personal risk perception. Finally, communications programs should aim to increase adolescents' self-efficacy, particularly in terms of their perceived ability to convince partners to use condoms and to use them correctly.

No abstract

This study describes the levels of sexual risk behavior and condom use among Cameroonian urban youth in order to evaluate the need for reproductive health programs targeting youth and to inform the design of such programs. We use data from a survey conducted in July-August 2000 among a representative sample of 1,956 unmarried youth aged 15-24 years. The data show that in urban Cameroon, first intercourse often occurs at an early age. Despite the HIV epidemic, a substantial fraction of youth, particularly males, continue to have high rates of partner change. A substantial fraction of youth consistently use condoms with casual partners. However, consistent condom use in regular relationships remains low, even though many youth have multiple regular partners. These findings illustrate the need for youth-targeted reproductive health programs in urban Cameroon. To ensure that youth are reached before they adopt risky behaviors, there is a need for programs that target very young teenagers and emphasize consistent condom use.

The aim of this study was to understand gender differences in components of condom use self-efficacy to inform the design of effective reproductive health interventions for youth. Data stem from a July to August 2000 reproductive health survey among youth aged 15-24. Gender differentials in self-efficacy are analyzed using logistic regression. Perceived ability to discuss and negotiate condom use is high for both sexes. Women are less likely than men to know correct condom use (58% vs. 80%, p<.01) but are more likely to be shy buying condoms (67% vs. 50%, p<.01). Prior experience buying and using condoms, parental support, and condom promotion affect perceived ability to correctly use condoms and shyness buying condoms. Programs aiming to increase self-efficacy in condom use should focus on increasing confidence in youth's ability to buy condoms and to use them correctly, especially for young women. There is a need for programs that publicize and/or increase access to youth-friendly outlets and increase the acceptability of young women buying condoms.

The objective of this study was to identify the key determinants of condom use with regular and casual partners among youth in Madagascar. Data stem from a reproductive health survey conducted in October-December 2000 among a representative sample of 2440 youth aged 15-24 living in Toamasina province. Following theoretical models of behaviour change, logistic regression was used to assess the effect of AIDS awareness,personal risk perception, condom access, perceived condom effectiveness,self-efficacy and social support on condom use. Among sexually experienced youth, only about four in ten males and two in ten females have ever used condoms. Fewer than 15% of youth used a condom in last intercourse with their regular partner. Whether youth will try condoms appears to depend largely on the perceived effectiveness of condoms for family planning, access to a nearby condom source, parental support for condom use, and patterns of risky sexual behaviour. Young males' likelihood of using a condom with a regular partner increases significantly if they perceive condoms to be effective for family planning (OR=11.4; p=0.019). For females, it increases with level of self-efficacy (OR=2 1; p=0.042) and having discussed HIV prevention with someone in the last year (OR=2.8; p=0.022). Among males,condom use with casual partners is significantly higher among those who perceive themselves to be at high risk of sexually transmitted infections(OR=2.3; p=0.014), who believe condoms are effective for family planning(OR=2.8; p=0.048), who have good access to condoms (OR=2.9; p=0.002)and who perceive their parents support condom use (OR=1-7; p=0.048). In conclusion, very few youth in Toamasina are using condoms, highlighting the need to continue and expand adolescent reproductive health interventions. In this low HIV prevalence setting, it is important for these programmes to emphasize that condoms are effective for both pregnancy prevention and STI/HIV prevention.