The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.

Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave) may be an important determinant of condom use. However, the relationsh...

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Main Authors: Kristin Fladseth, Mitzy Gafos, Marie Louise Newell, Nuala McGrath
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0122671
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author Kristin Fladseth
Mitzy Gafos
Marie Louise Newell
Nuala McGrath
author_facet Kristin Fladseth
Mitzy Gafos
Marie Louise Newell
Nuala McGrath
author_sort Kristin Fladseth
collection DOAJ
description Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave) may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372) and men (158) who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18). Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner's HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95-26.75); the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality.
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spelling doaj-art-24b65d5f82fd4d9e8a6127f70a47fd4f2025-08-20T03:46:43ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01104e012267110.1371/journal.pone.0122671The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.Kristin FladsethMitzy GafosMarie Louise NewellNuala McGrathCritical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave) may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372) and men (158) who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18). Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner's HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95-26.75); the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality.https://doi.org/10.1371/journal.pone.0122671
spellingShingle Kristin Fladseth
Mitzy Gafos
Marie Louise Newell
Nuala McGrath
The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.
PLoS ONE
title The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.
title_full The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.
title_fullStr The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.
title_full_unstemmed The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.
title_short The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.
title_sort impact of gender norms on condom use among hiv positive adults in kwazulu natal south africa
url https://doi.org/10.1371/journal.pone.0122671
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