Condom use consistency among adolescents and young adults in the Cape Area of South Africa: Dynamics and Determinants

This paper examined the dynamics and determinants of consistent use of condoms among youths in the Cape Area of South Africa. A longitudinal data of 3,210 young people collected between 2002 and 2005 was analysed using Stata/SE version 12 with Generalised Linear Latent And Mixed Model (GLLAMM) for multi-level modelling based on Social Cognitive Theory. Findings reveal that median age at first sexual intercourse remains at 16 years during the study period. The respondents who always use condoms decreased from a high of 69% at the baseline to 47% at the third wave in 2005, while inconsistent users of condoms at their most-recent sexual intercourse increased from 31% at the baseline to 53% in 2005. Self-efficacy of using condoms at first sexual intercourse, positive school attitude and participation in prosocial activities increased the odds of consistently using condoms at the event of most-recent sexual intercourse, while childhood place of residence being rural reduces the odds of consistently using condoms at the event of most-recent sexual intercourse. At the second wave of data collection in 2003/2004, those out of school were significantly less likely to consistently use condoms at the most-recent sexual intercourse (OR: 0.90; p<0.05) while at the third wave of data collection in 2005, age, sex, population group, degree of happiness, expectation to live long and school attendance predicted condom use consistency. Those adolescents who used condoms at their first sexual intercourse, those who believed in condoms as a way of protecting against HIV/AIDS, those who were Christians and those with external monetary support were significantly more likely to consistently use condoms at their most-recent sexual intercourse in 2005. Therefore, program and policy interventions must be designed to encourage consistent use of condoms in the study area.