Factors Affecting Condom Adoption Among Rural African-American Women in Intervention and Control Communities
Public Deposited- Last Modified
- January 25, 2020
- Creator
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Wang, Caroline
- Affiliation: Gillings School of Global Public Health, Public Health Leadership Program
- Abstract
- Background: From 1996-1998, a lay health advisor (LHA) intervention was implemented to decrease STD transmission in a rural African-American community with high rates of STDs. Evaluation after 18 months found increases in care-seeking activities and consistent condom use with main partners, but the proportion of women who ever used a condom with their main partners did not change. Over the same period of time, evaluation of a comparison community found decreases in care-seeking, and increases in both consistent condom use and the proportion of women who used condoms with their main partners. Objectives: In this analysis, we sought to identify factors affecting condom adoption in these rural communities. Furthermore, we sought to explain how some communities might more readily adopt safe sexual behaviors than others. Methods: From post-intervention surveys conducted in 1998, we examined various demographic, attitudinal, and contextual factors for their effect on condom non-use in the two communities. Cross tabulations and Pearson's chi-square were used to determine whether any of these factors were more prevalent in either community. Combining data from the two communities, independent predictors were identified by logistic regression. Interaction terms were also tested in the logistic regression to identifY any factors that operated differently on condom adoption in the two communities. Results: For both communities, the belief that condom use implies distrust of or unfaithfulness to one's main partner significantly predicted non-use. Partner belief that condoms are for new partners also predicted non-use. On the other hand, positive attitudes predicted condom adoption. Compared to the comparison community, more women in the intervention community were married, cohabiting with their main partners, and unopposed to pregnancy. Each of these variables also independently predicted condom non-use. All except one predictor operated similarly in both communities. Conclusions: Rates of marriage, cohabitation, and desire for pregnancy can affect a population's readiness to adopt condom use with main partners. Yet, increased prevalence of these factors is not always associated with a corresponding decrease in prevalence of multiple sexual partners. There is a need for future STD prevention efforts to help heterosexual populations overcome barriers of distrust associated with condom use, and to develop strategies for condom adoption among married or cohabiting partners in high risk populations.
- Date of publication
- May 2002
- DOI
- Resource type
- Rights statement
- In Copyright
- Note
- Track: HC&P
- Paper type: Research or research design
- Advisor
- Kissinger, Linda
- Degree
- Master of Public Health
- Degree granting institution
- University of North Carolina at Chapel Hill
- Graduation year
- 2002
- Language
- Deposit record
- 564d1737-ca9b-4211-9c3e-c1926665c3df
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