Ankomah Augustine, Adebayo Samson B, Anyanti Jennifer, Ladipo Olaronke, Ekweremadu Bright
Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana.
HIV AIDS (Auckl). 2013 May 24;5:97-109. doi: 10.2147/HIV.S38965. Print 2013.
Extramarital sex is a high-risk behavior in terms of Human Immunodeficiency Virus (HIV) transmission, yet condom use in extramarital relationships is an understudied area in Africa, and Nigeria in particular, where such liaisons are not uncommon. This study highlights key determinants of condom use among men who engage in extramarital sex in Nigeria.
Results are based on a subsample of 642 married men from a combined dataset from three waves of the National HIV/AIDS and Reproductive Health Survey (NARHS), a set of multiround nationally representative surveys. Logistic regression was employed to explore possible determinants of condom use in extramarital sex. The motivation, opportunity, and ability model was applied in selecting the determinants.
HIV risk-reduction knowledge was found not to be associated with condom use. At the full logistic regression model, being of the Yoruba tribe, having no misconception about HIV transmission, ability to discuss condom use, and ability to wear condoms were the key variables significantly associated with condom use in extramarital sex.
Implementing HIV risk-reduction behavior change requires more than knowledge. Behavioral skills in condom use are critical. Intervention efforts should move away from knowledge about risk to concentrate on improving skills on how to discuss condom use and wear condoms correctly.
就人类免疫缺陷病毒（HIV）传播而言，婚外性行为是一种高风险行为，但在非洲，尤其是尼日利亚，婚外性关系中避孕套的使用是一个研究较少的领域，而在尼日利亚，这种关系并不罕见。本研究强调了尼日利亚婚外性行为男性中避孕套使用的关键决定因素。
结果基于来自全国艾滋病毒/艾滋病和生殖健康调查（NARHS）三轮综合数据集的642名已婚男性子样本，NARHS是一组多轮全国代表性调查。采用逻辑回归来探索婚外性行为中避孕套使用的可能决定因素。在选择决定因素时应用了动机、机会和能力模型。
发现降低HIV风险的知识与避孕套使用无关。在完整的逻辑回归模型中，属于约鲁巴部落、对HIV传播没有误解、有讨论避孕套使用的能力以及有佩戴避孕套的能力是与婚外性行为中避孕套使用显著相关的关键变量。
实施降低HIV风险的行为改变需要的不仅仅是知识。使用避孕套的行为技能至关重要。干预措施应从关注风险知识转向专注于提高如何讨论避孕套使用和正确佩戴避孕套的技能。
