PREDICTORS OF AIDS KNOWLEDGE, CONDOM USE AND HIGH-RISK SEXUAL-BEHAVIOR AMONG WOMEN IN DAR-ES-SALAAM, TANZANIA

Reducing the number of sex partners and using condoms are the major me ans for individuals to protect themselves from STDs and AIDS in sub-Sa haran Africa. To identify predictors of having only one sex: partner i n the last year and to assess knowledge and use of condoms among women of reproductive age in Dar-es-Salaam, Tanzania, we interviewed 2285 w omen at 3-representative family planning clinics between February 1998 and Tune 1992. After interview, blood and genital specimens were coll ected for laboratory diagnosis of HIV and other sexually transmitted d iseases (STDs). Although knowledge of sexual transmission of AIDS was very high, less than a half of the respondents (42.8%) mentioned use o f condoms as an AIDS preventive measure. Younger and more educated wom en were more likely to mention use of condoms for AIDS prevention, how ever only 4.6% of women interviewed were regular users of condoms, whi le 19.8% were occasional users. The majority of women who had never us ed a condom (57.5%) reported not using condoms because 'men did not li ke them'. Condom use was positively associated with increasing level o f education and increasing number of sexual partners. 14.8% of women r eported having more than one sex partner in the last year; this behavi our was more likely among cohabiting women (increased by 210%); HIV-po sitives (increased by 120%); and among women with STDs (increased by 5 0%). The fact that condom use was positively associated with factors p reviously shown to be risk factors for HIV in this population suggests that AIDS prevention activities have been partially successful in rea ching women at risk. However, condoms were still only used by a minori ty of women in the high-risk strata of these risk factors.: Men's nega tive attitude about condoms was identified as the major reason for low condom usage; interventions aiming at increased condom use need to ta rget male attitudes.