Individual and partnership characteristics associated with consistent condom use in a cohort of cisgender men who have sex with men and transgender women in Nigeria

Abstract

Background This study reports on the individual and partnership characteristics that influence consistent condom use in cisgender men who have sex with men (MSM) and transgender women (TGW) attending trusted community centers that provide HIV prevention and treatment services in Nigeria. Methods Adults assigned male at birth who reported anal sex with male partners who enrolled between March 2013–2019 and had information about at least one male sexual partner were included in these analyses. At enrollment and follow-up visits every 3 months for up to 18 months, participants were administered detailed questionnaires that collected information about demographics, sexual practices, HIV risk behaviors, and characteristics and behaviors of their partners in the previous year (at enrollment) or the preceding 3 to 6-months (at follow-up visits). Logistic regression models with generalized estimating equations were used to assess the odds ratio (OR) and 95% confidence intervals (CI) of individual, partner, and partnership characteristics associated with consistent condom use (CCU). A participant was defined as consistently using condom if they reported always using condoms all the time they had insertive, receptive or both types of anal sex with a male partner. Results At the individual level, CCU was positively associated with higher education, disclosure of key population status to a healthcare worker and negatively associated with poor access to condoms. At the partner and partnership level, CCU was associated with partners with higher education (aOR: 1.36; 95% CI: 1.07–1.72), casual relationships (aOR: 1.22; 95% CI: 1.11–1.34) and relationships in which partners encouraged the participant to use condoms with other partners (aOR: 1.14; 95% CI: 1.02–1.28). Relationships in which the partner was married to a woman and/or the partner’s HIV status positive or unknown were negatively associated with CCU. Conclusions These findings suggest that individuals in relationships where partners were more open and encouraged safer sex were more likely to consistently use condoms. HIV prevention programs should consider leveraging communication to sexual partners to encourage condom use as this may support condom use with other sexual partners. Given sustained and growing HIV and STI epidemics among MSM and TGW, even with pre-exposure prophylaxis scale-up, it is crucial to continue to study optimal implementation strategies to increase condom use.

Consistent condom use and associated factors among HIV positive women of reproductive age on anti-retroviral treatment in Ogun state, Nigeria

“…This should be expected as consistent condom use is supposed to reduce the chances of HIV transmission, hence some PLHIV may embrace consistent use of condoms since they may not want their partners to get infected. This finding compares with a study done among group of MSM in Nigeria which showed partners HIV positivity as a negative predictor of consistent condom use [ 28 ]. Surprisingly, this finding contrasts with the findings from the studies in Malawi, Ethiopia, and Brazil where there was no significant association between consistent condom use and partner´s HIV status [ 13 , 21 , 25 ].…”

Determinants of consistent condom use among Filipino women: Results from the 2017 Philippine National Demographic and Health Survey

“…However, taken together with the low reach of various campaigns on contraceptive use throughout different forms of media, these findings underscore the need to strengthen sex education and promote optimal reproductive health behaviors, such as consistent condom use, in the general population. After adjusting for other variables, only agency showed a strong evidence of being associated with consistent condom use, which has been demonstrated in a previous study [ 42 ]. Other variables, such as HIV knowledge and hearing about contraception in television showed weaker associations with consistent condom use.…”

Inconsistent condom use with casual partners among men who have sex with men in Brazil: a cross-sectional study

“…The relationship established with the sexual partner seems to be an essential component of condom use among MSM. Studies suggest that there is a higher use of condoms in sexual relations between casual partners when compared to steady partners, due to a possible perception of lower risk and monogamy between the parties 12 , 13 . However, few studies seek to understand the factors associated with inconsistent condom use among casual partners, especially in low- and middle-income countries 14 , 15 .…”