ABSTRACT
Background: Condom use is critical for preventing sexually transmitted infections (STIs), such as Human Immunodeficiency Virus (HIV), and unintended pregnancies, in a comprehensive and long-term way. However, majority of people in sub-Saharan Africa do not use condoms leading to the high rates of sexually transmitted infections (STIs), such as Human Immunodeficiency Virus (HIV), and unintended pregnancies. The youths are not exempted from these public health concerns as they also practice unprotected sexual intercourse. In 2014, UNAIDS estimated 50% of new HIV cases to be among the youths, 3.9 million living with HIV throughout the world and about 84 % from sub-Saharan Africa. In 2020 WHO estimates that 10 million unintended pregnancies occur each year among adolescent girls aged 15–19 in developing countries. Malawi recorded 38,000 new HIV cases in 2018 and one-third of these cases were among the youth.
Objectives: The study looked at the prevalence and determinants of condom use among Malawi's youths.
Methodology: The study used the “Health Belief Model” in describing the behaviors of the youths concerning using a condom. A cross-sectional study was carried out that utilized Archival data for sexually active 15 to 24-year-old males and females within 4 months before the study was extracted from the "2015-2016 Malawi Demographic Health Survey (MDHS)" data set. Permission was obtained from the Demographic Health Survey (DHS) program to make use of the data. Data for male and female youth aged 15 to 24 who were sexually active for the past 4 months before the study was filtered from the individual man and woman's records. Data of 1,543 males and 5,143 females were retained and analyzed using SPSS version 20. The analysis used descriptive, bivariate, and binary logistic regression.
Results: The study established a low prevalence (27.1%) of condom use among the youths in the last sexual intercourse within 4 months before the study. In terms of sex males (55.8%) used condoms than female (18.5%) youths. The significant predictors of condom use among the male and female youths were: sex (OR 0.39 CI 0.33-0.47), youths aged 20-24 (OR 0.80 CI 0.68-0.95), ever married (OR 0.07 CI 0.06-0.08), central (OR 0.56 CI 0.40-0.77), southern regions (OR 0.59 CI 0.42-0.83), residing in the rural area (OR 0.74 CI 0.61-0.90) and ever tested of HIV (OR 1.29 CI 1.03-1.55).
Conclusion and recommendation: having established low prevalence of condom use among the youth in Malawi, there is a need to scale up programs and policies that target the youths to practice safe sex, which will assist in addressing the challenges of STIs, including HIV, and preventing unwanted pregnancies in Malawi.
