Condom use correlates among youth living with HIV in South Africa: lessons for promoting safer sex

Identifying factors associated with condom use can help inform the design of sexual reproductive health interventions for young people living with HIV. Data were collected from 294 sexually active youth in South Africa aged 14-24 years, living with HIV and aware of their status. Logistic regression found condom use was associated with partner status, disclosure, treatment adherence, knowledge, alcohol use, enacted stigma, and age at known status. Seventy-seven percent reported condom use at last sex, with higher odds among those who: disclosed their status to their last partner (OR = 2.13, 95% CI = 1.09-4.15), had not missed any ART doses in the previous week (OR = 2.67, 95% CI = 1.35-5.27), knew to use condoms when both partners have HIV (OR = 2.65, 95% CI = 1.34-5.25) and learned their status by age 12 (OR = 2.89, 95% CI = 1.30-6.43). Lower odds of condom use were among participants with an HIV-positive partner (OR = 0.36, 95% CI = 0.18-0.73), those who experienced recent stigma (OR = 0.55, 95% CI = 0.31-1.00), who drank at least 1 day per month (OR = 0.43, 95% CI = 0.22-0.84) and females (OR = 0.41, 95% CI = 0.20-0.84). Condom education and services promoting stigma management and safe disclosure could increase condom use among young people living with HIV. Lower condom use among adolescents reporting non-adherence to treatment underscores the critical need for effective interventions.