In Cameroon, as in many sub-Saharan African countries, high-risk sexual activity is common among young people. A third of women aged 15-19 are pregnant or have had children, and a similar fraction of both sexes have had a sexually transmitted infection (STI). How can young people be encouraged to use condoms? Who influences their decisions most: their peers or parents?

To reduce the incidence of STIs and mistimed pregnancies, both governmental and non-governmental organisations are implementing youth-oriented reproductive health programmes. However, few directly promote and distribute condoms, focusing instead on promoting abstinence.

A study from Population Services International (PSI) examines the factors affecting condom use among youth in urban Cameroon and aims to inform the design of future phases of "100% Jeunes", a youth-oriented condom social marketing programme. The research analyses data from interviews with over 2000 unmarried sexually experienced youth aged 15-24 from Yaounde and Douala.

The interviews included questions to establish respondents’ perceptions about the severity of HIV/AIDS, condom access and effectiveness, social support, self-efficacy and personal risk. Self-efficacy is one's perceived ability to reach a goal, here, respondents were deemed to have self-efficacy if they believed they had the ability to perform at least three of five following activities with their partner:

• refuse sex with that partner
• ask about sexual history
• discuss STIs
• discuss condom use
• convince a partner to use condoms with them.

Key findings from the study include:

• Over three quarters of either sex have ever used a condom but only 45 per cent of males and 34 per cent of females used a condom in their last sex act with a regular partner.
• These rates increased to 60 per cent and 47 per cent respectively with a casual partner but the rates of respondents who always used condoms were considerably lower.
• Males who feel they have parental support for condom use are 1.6 times more likely to have ever used condoms and females 2.6 times more likely. Peer support has no significant effect on either sex.
• Young men who perceive themselves to be at moderate to high risk of HIV infection are 2.4 times more likely to report having used a condom in their last act with a casual partner.
• Other key determinants for condom use among young men include being within ten minutes walk of a condom source, having had multiple sexual partners and having ever discussed family planning or STI prevention.
• The likelihood that a young female used a condom with her regular partner in their last sex act increases significantly with level of self-efficacy and decreases with age.

Recommendations for policy-makers aiming to increase the number of new condom users and to encourage continued use among youth include:

• encouraging parents to discuss reproductive health issues with their teenage children
• increasing awareness among youth of their personal risk of contracting HIV/AIDS and dispelling the myth that the risk of HIV infection with regular partners is low
• running campaigns which focus on individual responsibility and empowerment, using mass media and interpersonal components.

Source(s):
‘Determinants of Condom Use among Unmarried Youth in Urban Cameroon’, by D. Meekers and M. Klein, Studies in Family Planning, 33 (4), December 2002

Funded by: Population Services International; Gates Foundation; UK Department for International Development

id21 Research Highlight: 24 October 2002

Further Information:
Rebecca Cramer
Research Division
PSI
1120 19th Street, NW
Suite 600
Washington DC, 20036
USA

Tel: (202) 785 0072
Fax: (202) 785 0120
Contact the contributor: research@psi.org

Population Services International

Other related links:
See id21's collection of links relevant to sexual and reproductive health.