Married and cohabiting women have been neglected in the promotion of condoms as the most effective prevention method of sexually transmitted infections (STIs) and HIV. As a result, HIV prevalence is increasing in this population group in high HIV prevalence settings. The study assesses the prevalence of and identifies the predictors of consistent use of male condoms among married and cohabiting women, and examines its implications for HIV transmission. The data used were obtained from a cross-sectional survey on sexual and reproductive health conducted among women aged 18–49 years of age in Mahikeng Local Municipality in 2012 using mixed methods. A structured questionnaire and in-depth interview guide were used to collect quantitative data from 568 and qualitative data from 33 married or cohabiting women. The data were analysed using logistic regression and thematic content analysis methods. The results show that only 16.2% of the women consistently used condoms. Women having no and 1–2 surviving children, educated women, women in relationships in which most sexual decisions were jointly made with husbands/partners, women having high risk perceptions of STIs and HIV infection and women who negotiate condom use with and know the HIV status of their husbands/partners were significantly more likely to have consistently used condoms. However, women who perceived that condoms reduce sexual pleasure, feared they would be blamed for infidelity by husbands/partners, trusted that their husbands/partners were faithful and feared condoms could lead to relationship instability used condoms inconsistently. We conclude that the prevalence of consistent use of condoms by married and cohabiting women in the study is low, indicating that promotion of condoms among married or cohabiting women is neglected, which could increase the risk of HIV transmission. Based on our findings, we recommend the review of condom programmes with a view to targeting married or cohabiting couples as an important group for condom promotion and uptake.

中文翻译：

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南非Mahikeng已婚和同居妇女使用避孕套及其对HIV感染的影响

已婚和同居妇女在推广避孕套方面被忽视，因为避孕套是预防性传播感染和艾滋病毒的最有效方法。结果，在艾滋病毒高发地区，该人群的艾滋病毒流行率正在增加。这项研究评估了已婚和同居妇女中男性避孕套的使用率并确定了其预测因素，并研究了其对艾滋病毒传播的影响。所用数据来自2012年在Mahikeng Local Municipality对18-49岁女性进行的性与生殖健康横断面调查，采用混合方法。使用结构化的问卷和深入的访谈指南收集了568位患者的定量数据和33位已婚或同居女性的定性数据。使用逻辑回归和主题内容分析方法分析数据。结果表明，只有16.2％的女性坚持使用安全套。没有子女和有1-2个尚存子女的妇女，受过教育的妇女，与丈夫/伴侣共同做出大多数性决定的关系中的妇女，对性传播感染和艾滋病毒感染有高风险认识的妇女以及与艾滋病毒谈判使用安全套并了解艾滋病毒的妇女他们的丈夫/伴侣的状况显着更有可能一直使用安全套。但是，那些认为避孕套会降低性快感的妇女，担心丈夫/伴侣会责备她们不忠，相信她们的丈夫/伴侣是忠实的，并且担心避孕套会导致使用避孕套前后不一致的关系不稳定。我们得出的结论是，在研究中，已婚和同居妇女持续使用避孕套的普遍性较低，这表明忽略了已婚或同居妇女避孕套的推广，这可能会增加艾滋病毒传播的风险。根据我们的发现，我们建议对安全套方案进行审查，以将已婚或同居夫妇作为促进和吸收安全套的重要人群。