Stigma of infidelity associated with condom use explains low rates of condom uptake: qualitative data from Uganda and Tanzania

Reproductive Health

Research

Juliet Mwanga-Amumpaire¹  Kathryn Broderick²  Christine Aristide²  Brooke W. Bullington³  Radhika Sundararajan⁴  Jennifer A. Downs⁵ 

[1] Mbarara University of Science and Technology, Mbarara, Uganda;Weill Cornell Medical College, 525 East 68th Street, Room M130, 10065, New York, NY, USA;Weill Cornell Medical College, 525 East 68th Street, Room M130, 10065, New York, NY, USA;Burlington Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA;Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, USA;Weill Cornell Medical College, 525 East 68th Street, Room M130, 10065, New York, NY, USA;Weill Cornell Medicine, Center for Global Health, New York, USA;Weill Cornell Medical College, 525 East 68th Street, Room M130, 10065, New York, NY, USA;Weill Cornell Medicine, Center for Global Health, New York, USA;Weill Bugando School of Medicine, Mwanza, Tanzania;

关键词: Male condom;    External condom;    HIV/AIDS;    Eastern Africa;    HIV prevention;   

DOI  :  10.1186/s12978-023-01563-6

 received in 2022-05-11, accepted in 2023-01-04,  发布年份 2023

来源: Springer

【 摘 要 】

Despite widespread messaging supporting male (external) condom use to prevent HIV in endemic settings, utilization of condoms is low across sub-Saharan Africa. A thorough understanding of barriers to condom use as a form of HIV prevention is necessary to reduce HIV transmission. Here, we present qualitative data from rural eastern Africa to explain low utilization of condoms among heterosexual adults. Focus groups and interviews were conducted in Tanzania and Uganda between 2016 and 2019. A content analysis approach was used to identify attitudes about condoms and factors related to use/non-use. We found that strategies such as abstinence and being faithful to one’s partner are perceived as ideal but rarely achievable methods of HIV prevention. Condoms are used in the setting of “failure” to abstain or be faithful and are therefore stigmatized as markers of infidelity. As such, use within cohabiting and long-term relationships is low. Our data suggest that negative perceptions of condoms may stem from persistent effects of the formerly applied “ABC” HIV prevention approach, a public health messaging strategy that described A—abstinence, B—be faithful, and C—use a condom as tiered prevention tools. Condom uptake could increase if HIV prevention messaging acknowledges existing stigma and reframes condom use for proactive health prevention. These studies were approved by Weill Cornell Medicine (Protocols 1803019105 and 1604017171), Mbarara University of Science and Technology (Protocol 16/0117), Uganda National Council of Science and Technology (Protocol SS-4338), and the Tanzania National Institute for Medical Research (Protocol NIMR/HQ/R.8c/Vol.I/1330).

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 1

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