‘It’s not good to eat a candy in a wrapper’: male students’ perspectives on condom use and concurrent sexual partnerships in the eastern Democratic Republic of Congo

Abstract

This paper reports on fieldwork carried out in 2011 with aim to investigate young men’s perspectives about condoms use, concurrent sexual partnerships and sex in the context of HIV/AIDS. This study employed a qualitative approach to collect data from 28 boys aged 16–20 from two urban and two rural high schools in South Kivu province. Four focus group discussions and 20 individual interviews were conducted among them. The findings showed that most students identified condoms as unsafe and untrustworthy. Reasons given for the mistrust of condoms were related to the belief that condoms do not give enough protection from Sexually Transmitted Infections, HIV and pregnancies. Most participants believe that condoms have a ‘small hole’ or are unreliable and are therefore not effective in prevention. They also mentioned that condoms encourage inappropriate sexual activity. They prefer flesh-to-flesh sex rather than protected sex using a condom. However, a few participants acknowledged the importance of condom use. Despite the risk of HIV transmission, boys believe that it is appropriate for them to have concurrent sexual partnerships. They justified the concurrent sexual partnerships as a way of ensuring that they cannot miss a girl to satisfy their sexual desire. Given the boys’ failure to use condoms and their strong inclination to concurrent sexual partnerships, there is a need for heath groups and stakeholders within the area to increase awareness about condoms’ effectiveness and improve knowledge dissemination on Sexually Transmitted Diseases and how they are prevented.

Premarital relationships and condom use among young people in Suva, Fiji

“…15,[17][18][19] In many low and middle income countries (LMICs), there are powerful social and symbolic meanings attached to condoms, which discourage young people from using them, including the association of condoms with disease, immorality and promiscuity. 18,[20][21][22][23][24] As such, 'using a condom is not a simple physical actit also has social meaning'. 18 Understanding the contextual influences on condom use and how these connect with sexual health, risk-reduction practices and access to health services can enhance the design and delivery of more appropriate SRH care for young people.…”

Adolescent condom use in Southern Africa: narrative systematic review and conceptual model of multilevel barriers and facilitators

“… Between 32 and 48 14–20 Moyo & Rusinga, 2017 [ 52 ] Qualitative To understand the importance of reproductive health education to contraceptive use among adolescents Zimbabwe A total of 185 adolescents aged 15–19 years were sampled. 96 89 185 15–19 (mean 17) Mulumeoderhwa, 2018 [ 53 ] Qualitative To investigate young men’s perspectives about condom use, concurrent sexual partnerships and sex in the context of HIV/AIDS. Democratic Republic of Congo 28 boys aged 16–20 from two urban and two urban high schools in South Kivu provinces.…”

“…Key finding: A minority of studies reported positive attitudes towards condom use as a facilitator of condom use. - Twenty studies reported negative attitudes about condoms and condom use with the central attitudes being they are ineffective [ 38 , 39 , 41 , 45 , 52 , 53 , 57 ], cause disease [ 43 , 51 , 53 , 56 , 57 ], reduced sexual pleasure for men [ 39 , 40 , 42 , 44 , 45 , 47 , 53 , 56 , 57 ], are morally inferior to abstinence outside of marriage [ 41 , 53 , 59 ], and represent a lack of trust in committed and transactional relationships [ 37 , 41 , 42 , 44 , 46 – 49 , 54 , 59 ]. - Two studies did report positive attitudes to condoms (generally related to their value in preventing STIs and unintended pregnancy) [ 43 , 49 ].…”

“… - Three studies reported male adolescent beliefs that girls who carry or use condoms are ‘easy’, untrustworthy and likely suffering from a STI [ 38 , 42 , 46 ]. Six studies reported adolescent girls fear of embarrassment or judgment if they sought to obtain, carried or requested to use condoms [ 44 , 46 , 48 , 51 – 53 ]. Three studies indicated that both males and females saw perceived stigma attached to adolescent sex as a barrier to obtaining condoms [ 51 , 52 , 59 ].…”

Factors Associated with Knowledge of Transmission and Prevention of HIV/ AIDS among Men and Women in Uganda: Evidence from Demographic Health Survey of Uganda 2016

“…Also some studies have suggested that specific interventions are needed to improve the utilisation of HIV testing amongst heterosexual drug users, particularly amongst non-injection drug users since they are at very high risk of HIV transmission [31]. A study carried out in Congo about male students' perspectives on condom use and concurrent sexual partnerships revealed low knowledge about prevention of sexually transmitted infection since majority of students said that they prefer flesh to flesh sex than using condom and this seems prevalent among school students [32].…”