Individual and Social Determinants of Attitudes Towards Condom Use and HIV Among Ghanaian Junior High School Students

Background and Purpose: Condom use remains low among sexually active youth in sub-Saharan Africa, including Ghana. Evidence suggests that attitudes towards condom use are highly related to actual condom use. Attitudes, in turn, are influenced by numerous factors at the individual, family and community-level. However, little is known about the predictors of condom use and HIV attitudes among youth in resource-limited countries. To address gaps in knowledge, I examined the individual and social determinants of attitudes towards condom use and HIV among Ghanaian youth.

Methods: A total of 6,252 youth from the Ghana YouthSave baseline data were included in this study. Attitudes towards condom use and HIV were measured using a multidimensional attitude scale based on the health belief model. Multilevel modeling was performed to examine individual and social determinants of attitudes towards condom use and HIV.    

Results: Most youth have positive attitudes towards HIV prevention. A majority of youth believe using condoms are an effective way to prevent getting infected with HIV. Parent-youth relationship, future orientation, commitment to school, and self-efficacy were statistically significant predictors of attitudes towards condom use and HIV (p < .05). Higher levels of future orientation were associated with positive beliefs about the benefits of condom use, severity of HIV, susceptibility of young people to HIV, and condom use efficacy. More frequent parent-youth interaction predicted positive attitudes towards condom use efficacy and perceived social support for condom use.      

Discussion: Results suggest that attitudes towards condom use and HIV are shaped by individual and social factors. Some factors exist primarily in the individual, others in families, and some in communities. Understanding and identifying the individual and social factors that influence HIV prevention attitudes may guide development of holistic interventions that are designed to increase young people’s positive beliefs about condom use. Improving young people’s attitudes towards HIV prevention might contribute to consistent use of condoms, which in turn, reduces risk of HIV acquisition.