Knowledge, Practices, and Factors Affecting use of Condoms among the Youths in Lira District in HIV Prevention
Otim, Aaron Thomas
As Uganda continues with the fight to end HIV epidemic by 2030, increasing condom use, especially in high-risk sexual encounters is one of the key strategies for reducing HIV transmission in Uganda. This study aimed to assess the knowledge, practices and factors affecting the utilization of condoms in the prevention of HIV among youths in Lira District. The study adopted a cross-sectional study design employing quantitative methods. A total of 189 respondents aged 15-35 years were recruited using a systematic random sampling technique. Data was obtained using an interviewer administered questionnaire and analysed using SPSS version 2.0. Descriptive analysis was used to generate frequencies and percentages. The measure and significance of association were determined using a Chi-square test and odds ratios with a P-value set at 0.05 corresponding to 95% confidence interval. Linear logistic regression analysis was used to generate Crude and Adjusted odds ratios to determine the factors associated with condom use among youths in HIV prevention. The results showed that 48% had ever used condoms. Majority had knowledge of condom use. Over 120(63.49%) were very knowledgeable, 28(14.82%) moderately knowledgeable while the rest 41(21.69%) were less knowledgeable. Likewise, over three quarters 71(78.02%) reported good condom use practices. Marital status (p=0.002), education (p=0.012), relationship status (p=0.019), number of sexual partners (p=0.011) and knowledge about condom use (p=0.018) were significant predictors of condom use in HIV prevention. Only marital status was independently associated with condom use after adjusting for possible cofounders. Although the study reveals relatively good knowledge and condom use practices, there is still some level of less knowledge and poor practices which may be driving the high prevalence of not using condoms among youths in HIV prevention. Reproductive health education programs targeting married, less educated, and youths in more than a single relationship should be tightened so as to increase condom use knowledge and eventually utilization in the fight against HIV.
Keywords:Condom, HIV epidemic and sexually transmitted infections (STIs).
In 2013, an estimated 2.1 million people became newly infected with HIV (Joint United Nations Programme on HIV/AIDS , . An estimated 500 million people acquired chlamydia, gonorrhoea, syphilis or trichomoniasis. According to  it is estimated that every year more than 200 million women have unmet needs for contraception leading to approximately 80 million unintended pregnancies. These three public health priorities require a decisive response using all available tools, with condoms playing a central role (World Health Organisation . Condoms are a critical component in a comprehensive and sustainable approach to the prevention of HIV and other sexually transmitted infections (STIs) and are effective for preventing unintended pregnancies . Male condoms offer dual protection against HIV and other sexually transmitted infections (STIs), as well as unplanned pregnancy . Male and female condoms are the only devices that both reduce the transmission of HIV and other sexually transmitted infections (STIs) and prevent unintended pregnancy . Laboratory studies show that condoms provide an impermeable barrier to particles the size of sperm and STI pathogens, including HIV (UNFPA/Guttmacher Institute) . Condoms, when used consistently and correctly, are highly effective in preventing the sexual transmission of HIV.
Today, HIV/AIDS has continued to be a serious international health concern, and sub-Saharan Africa remains the most affected region. Over 25.6 million persons are currently living with HIV in sub-Saharan Africa. This accounts for two-thirds of the recent overall world HIV infections and more than 70 percent of all AIDS related deaths. In 2015, Eastern and Southern Africa had about 7.1% adult HIV prevalence rate (about 19 million HIV patients), while Western and Central Africa accounted for about 2.2% (about 6.5 million HIV patients) .
In Uganda an estimated 1.3 million people were living with HIV and an estimated 26000 Ugandans died of AIDS related illnesses. In 2017, an estimated 1.3 million people were living with HIV, and an estimated 26,000 Ugandans died of AIDS-related illnesses .
The HIV infection rate in Lira District has dropped by 1.8 per cent between 2014 and 2019, from 8.9 percent to 7.1 per cent, according to new estimates from the district health department, what has been termed as “good progress” in the fight against HIV/AIDS due to the ongoing health education and regular community sensitisation by both development partners and the district. The prevalence rate of HIV has been very high in Lira, which makes part of northern Uganda, mainly because of the Lord’s Resistance Army (LRA) insurgency. Areas that are still being considered hot spots in terms of new HIV infections include; bars, bus parks, Juba Road, Kitgum stage, and Amach Cattle Market. In these hot spots, much as been tried to fight the disease through various interventions but HIV is still escalating. One of the reasons for this escalation is low use of condoms and practice of risky sexual behaviours .
For the above highlighted reasons, with all the efforts being made to reduce the incidence and the spread of HIV/AIDs especially among the youths, this study is intended to assess knowledge, practices and socio demographic factors affecting the utilisation of condoms among the youth in Lira as condom plays a central role in the prevention of HIV.
In 2017, there were 19.6 million people living with HIV (53%) in eastern and southern Africa, 6.1 million (16%) in western and central Africa, 5.2 million (14%) in Asia and the Pacific, and 2.2 million (6%) in Western and Central Europe and North America .
Despite advances in our scientific understanding of HIV and its prevention and treatment as well as years of significant effort by the global health community and leading government and civil society organizations, too many people living with HIV or at risk for HIV still do not have access to prevention, care, and treatment, and there is still no cure .
The HIV epidemic not only affects the health of individuals, it impacts households, communities, and the development and economic growth of nations. Many of the countries hardest hit by HIV also suffer from other infectious diseases, food insecurity, and other serious problems . Progress also has been made in preventing mother-to-child transmission of HIV and keeping mothers alive. In 2017, 80% [61– >95%] of pregnant women living with HIV had access to antiretroviral medicines to prevent transmission of HIV to their babies, up from 47% in 2010. However, despite the availability of this widening array of effective HIV prevention tools and methods and a massive scale-up of HIV treatment in recent years, new infections among adults globally have not decreased sufficiently.
Data from  identified existing gaps in HIV programmes and specific populations that need special focus. HIV prevalence triples from those aged 15-19 years (1.1 % total, 1.8% in girls and 0.5% in boys) to those aged 20-24 years (3.3 % total, 5.1% in young women and 1.3% in young men), and then almost doubles again between 20-24 and 25-29 (6.3% total, 8.5% in women and 3.5% in men) suggesting new infections remain an issue in these age groups. This continuing infection risk necessitates innovative interventions to prevent new infections in young people.
Uganda like many countries in Sub Saharan Africa, has seen an emerging epidemic among the adolescents and the young adults. This brings about a major setback in the achievements made and calls for refocusing in the priority areas .
With the Goal of HIV prevention being, reducing the number of new youth and adult infections by 70% and the number of new paediatric HIV infections by 95% by 2020, through implementation of the combination prevention strategies that focus on adoption of safer sexual behaviours, scaling up biomedical interventions and HCT as well as addressing the underlying social-cultural drivers of the epidemic. The activities carried out to achieve the objectives include Behaviour Change Communication (BCC), HIV Testing and Counselling (HTC), Prevention of Mother to Child HIV Transmission (PMTCT), Safe Male Circumcision (SMC), condom promotion and provision, activities for key population .
HIV prevention aims at, reducing the number of new HIV infections, increased coverage and utilization of prevention services and increased adoption of safer sexual behaviour and reduction of risky behaviours .
With all the above aims centred on the utilisation of condoms the research will help identify the gaps in condom utilisation and these will help in development of new strategies and strengthening the existing in the fight to prevent new infections mainly among the youth that has of recent been on a great rise.
Our study revealed relatively good knowledge and practices regards condom use in majority of the respondents. Poor knowledge and practice were however also consistent with our study. Factors that were found to affect condom use included marital status, education, relationship status, number of sexual partners and knowledge about condom use. Only the marital status of the respondent was independently associated with condom use.
There is need to tighten public health campaigns educating youths about the importance of condoms in providing dual protection against pregnancy and HIV. This can be done through reproductive health talks targeting radios, cultural/religious institutions among others. The target groups should include married youths, those that are less educated and youths in more than a single relationship. This will help improve their perceptions of condom use and eventually their practices regard using condoms in HIV prevention.
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Otim, Aaron Thomas (2023). Knowledge, Practices, and Factors Affecting use of Condoms among the Youths in Lira District in HIV Prevention. IDOSR JOURNAL OF APPLIED SCIENCES 8(3) 85-100. https://doi.org/10.59298/IDOSR/2023/10.2.1416