Despite the declining trends of Human immunodeficiency virus
(HIV) infection in Sub-Saharan Africa (SSA), unsafe sexual behaviours among
adolescents still represent a public health challenge. It is important to
understand factors acting at different levels to influence sexual behaviour
among adolescents. This study examined the influence of perceived behaviour control,
subjective norms, attitudes and empowerment on intention to use condoms and
reported use of condoms among adolescents in rural Tanzania.
We used a questionnaire to collect data from 403 adolescents
aged 14 through 19 years from nine randomly selected secondary schools in
the Newala district located in the Southern part of Tanzania. The
self-administered questionnaire collected information on sexual practices and
factors such as attitudes, subjective norms, perceived behaviour control and
empowerment. Binary logistic regression was performed to identify factors
associated with intention to use and reported use of condoms.
Sexually active adolescents constituted 40.6 % of the
sample, among them 49.7 % did not use a condom at last sexual intercourse
and 49.8 % had multiple sex partners. Many (85 %) of sexually active
respondents had their sexual debut between the ages of 14 to 17 years. Girls
became sexually active earlier than boys. Perceived behaviour control predicted
intentions to use condoms, thus demonstrating its importance in
the decision to use a condom. Empowerment and a positive attitude predicted reported condom use, thus
turning the decision to actions. Subjective norms had only indirect effects on
intention and reported use of condoms.
The findings suggest that unsafe sex practices are prevalent
among school adolescents in rural areas of Tanzania. Perceived behaviour
control and positive attitudes predict intensions to use condoms whereas
empowerment predicts reported condom use. The findings may imply that safe sex
promotion interventions that simultaneously address socio-cognitive and
ecological determinants of sexual behaviours may improve adolescents’ safe sex
behaviours.
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1Department of Community Health, St. Francis
University college of Health and Allied Sciences, Ifakara, Tanzania
2School of Nursing and Public Health,
College of Health Sciences, The University of Dodoma, Dodoma, Tanzania
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