HIV risk perception and consistency in condom use among adolescents and young adults in urban Cape Town, South Africa: a cumulative risk analysis

Abstract

Background:The relationship between HIV risk perception and consistency in the use of condoms is scarcely understood in the context of a high HIV prevalence among adolescents and young adults in urban South Africa. Methods: Using data from Cape Area Panel Study (CAPS), gender-stratified analyses were conducted to determine relationship between risk perception and condom use among 14-22 year olds (n = 4 853) in urban Cape Town. Using discriminant function analyses, ecological determinants of consistency in condom use were determined and a cumulative risk approach examined. Results: A total of 1 598 sexually active youths, of mean age 17.7 years, with 785 (49%) of males and 813 (51%) females were identified for analyses. At baseline, 87% of males and 90% of females assessed themselves to be at no or low risk of HIV infection. At follow-up, 61% of males reporting low or no risk were consistently using condoms compared to 67% reporting some risk of HIV infection. In females, 47% reporting low or no risk consistently used condoms compared to 49% of those reporting to be at some risk. Conclusions: Perceived risk for HIV infection had no significant impact on consistency in using condoms for both males and females. Further, findings suggests that the effect of ecological risk factors was cumulative. Therefore, interventions aimed at the three levels ecology may be more effective in improving consistency as risk factors possess a cumulative effect.

Understanding Adolescent Risk Perceptions About Hiv and Aids in Kenya: Assessing the Effectiveness of the Trust Condom a Kuwa Truea Campaign

“…These findings concurred with other studies investigating the relationship between risk perception of acquring HIV and condom uptake which revealed that perceived risk for HIV infection had no significant impact on condom uptake (Muchiri, Odimengwu, & Wet, 2017;Stehr, 2006;Ashagrie, Tadesse, & Alebachew, 2016).They also resonated with the Harvard Mental Health Letter (2011)whichinformed us that risk perception was rarely entirely rational as people assessed risk through use of a mixture of cognitive skills by weighing the evidence and using reason and logic to reach a decision about risk.…”

Socioeconomic variations in risky sexual behavior among adolescents in 14 sub-Saharan Africa countries who report ever having had sex

“…The association between more years of schooling and condom use has been reported by other studies [ 15 ]; however, it is unclear whether this association is driven by potential exposure to sexual education or other determinants influencing risky behaviors [ 29 ]. In this regard, previous evidence has shown that sex education in schools is linked to positive effects on the consistent and correct use of condoms and that there is a need for out-of-school programs aimed at providing relevant instructions before adolescent become sexually active [ 10 ].…”

Acceptability and feasibility of a brief substance use intervention for adolescents in Cape Town, South Africa: A pilot study

“…Studies conducted in Cape Town, South Africa, have shown that adolescent substance use is correlated with poor physical health and mental health as well as delinquency. In terms of physical health, substance use in adolescence appears associated with risky sexual activity (Morojele & Ramsoomar, 2016; Muchiri, Odimegwu, & de Wet, 2017). This sexual risk behaviour elevates adolescents' risk of the acquisition of human immunodeficiency viruses (HIV), which is a major driver of the burden of disease in this country (Pillay‐van Wyk et al, 2016).…”