Baruwa Ololade Julius
Centre for Social Sciences Research, University of Cape Town, Cape Town, South Africa.
BMC Public Health. 2025 Mar 18;25(1):1040. doi: 10.1186/s12889-025-22315-0.
Effective condom use negotiation is crucial for reducing HIV risk and unintended pregnancies. While studies have emphasized condom use, they often overlook the negotiation process, a critical factor in mitigating sexual health risks. This study examines factors influencing condom use negotiation among adolescent girls and young women (AGYW) in Mozambique.
Data from the 2022-23 Mozambique Demographic and Health Survey (MZDHS) were analyzed, focusing on 2,624 AGYW aged 15-24. Condom use negotiation, defined as the ability to ask a partner to use a condom, was treated as a binary variable. Ten independent variables measured as binary, nominal, or ordinal were included: age, education, residence, wealth status, religion, early sexual debut, adolescent motherhood, multiple sexual partners, HIV testing, and inequitable gender attitudes. Multivariable logistic regression identified the predictors of condom use negotiation, with interaction terms assessing whether gender attitudes and condom negotiation varied by age. Average marginal effects were calculated to evaluate the impact of these factors.
Only 35.11% of AGYW reported the ability to negotiate condom use. Multivariate analysis showed that AGYW with secondary or higher education (adjusted Odds ratio [aOR] = 2.17, 95% Confidence Intervals [CI] = 1.48-3.17; p < 0.001) and those from rich households wealth index (aOR = 2.51, 95% CI = 1.81-3.48; p < 0.001) were more likely to negotiate. HIV testing was also associated with higher odds of condom use negotiation (aOR = 1.39, 95% CI = 1.01-1.91; p = 0.043). Conversely, inequitable gender attitudes reduced the likelihood of condom use negotiation (aOR = 0.62, 95% CI = 0.46-0.83; p = 0.001). AGYW aged 15-19 with inequitable attitudes had the lowest predicted probability of condom use negotiation (31%).
Findings emphasize the role of education, wealth, gender attitudes, and HIV testing in enhancing condom use negotiation among AGYW in Mozambique. Public health initiatives should address these factors to strengthen negotiation skills and support HIV prevention efforts.
有效的避孕套使用协商对于降低感染艾滋病毒风险和意外怀孕至关重要。虽然研究强调了避孕套的使用，但它们往往忽视了协商过程，而这是减轻性健康风险的关键因素。本研究调查了影响莫桑比克少女和年轻女性（AGYW）进行避孕套使用协商的因素。
对2022 - 2023年莫桑比克人口与健康调查（MZDHS）的数据进行了分析，重点关注2624名年龄在15 - 24岁的AGYW。将避孕套使用协商定义为要求伴侣使用避孕套的能力，并将其视为一个二元变量。纳入了10个以二元、名义或有序形式测量的自变量：年龄、教育程度、居住状况、财富状况、宗教信仰、初次性行为过早、青少年母亲身份、多个性伴侣、艾滋病毒检测以及不平等的性别态度。多变量逻辑回归确定了避孕套使用协商的预测因素，并通过交互项评估性别态度和避孕套协商是否因年龄而异。计算平均边际效应以评估这些因素的影响。
只有35.11%的AGYW报告有进行避孕套使用协商的能力。多变量分析表明，接受过中等或高等教育的AGYW（调整后的优势比[aOR] = 2.17，95%置信区间[CI] = 1.48 - 3.17；p < 0.001）以及来自富裕家庭财富指数的AGYW（aOR = 2.51，95% CI = 1.81 - 3.48；p < 0.001）更有可能进行协商。艾滋病毒检测也与更高的避孕套使用协商几率相关（aOR = 1.39，95% CI = 1.01 - 1.91；p = 0.043）。相反，不平等的性别态度降低了避孕套使用协商的可能性（aOR = 0.62，95% CI = 0.46 - 0.83；p = 0.001）。态度不平等的15 - 19岁AGYW进行避孕套使用协商的预测概率最低（31%）。
研究结果强调了教育、财富、性别态度和艾滋病毒检测在增强莫桑比克AGYW进行避孕套使用协商方面的作用。公共卫生举措应解决这些因素，以加强协商技能并支持艾滋病毒预防工作。
