PROBLEM STATEMENT: Despite rising rates of HIV infections in Malawi and the importance of condom use as an effective preventive measure, most people do not use condoms. The purpose of this study was to identify barriers and facilitators to condom use in Malawi. DESCRIPTION OF SUBJECTS: Thirty-two men and fifty-nine women were recruited from teacher training colleges, a nursing college, banks, and peri-urban prenatal clinics in Lilongwe and Blantyre. METHOD: This qualitative-descriptive study used eight focus groups originally conducted to identify HIV prevention issues in Malawi. Data were analyzed for themes related to condom use using Atlas.ti 4.2 software. RESULTS: Suggesting condom use raises strong trust issues in sexual relationships such as suspicions of infidelity and promiscuity. Other barriers to condom use included desire for procreation, lack of knowledge about condom effectiveness and correct use, difficulties in accessing and procuring condoms, and interference with people’s sexual pleasure. Most people expressed negative attitudes toward condoms. Nevertheless, others reported positive attitudes about condoms because they felt cleaner, experienced delayed ejaculation, and enjoyed protection from diseases. A few participants believed that some people deliberately did not use condoms with the aim of infecting others. Despite common convictions about churches not advocating condom use, none of the participants mentioned this as a barrier to using condoms. DISCUSSION: These results imply that HIV prevention and condom use messages in Malawi need to address issues of trust in sexual relationships. Education on condom usage and effectiveness is important to improve people’s confidence in using condoms. Strategies to increase condom availability and accessibility need to be put in place. Promotion of positive attitudes towards condoms and their effectiveness in preventing disease transmission should be included in prevention programs. KEYWORDS: condoms, barriers, facilitators
Session #1223 - Graduate Student Poster Session
The 29th Annual MNRS Research Conference (April 1-4, 2005)