Does community clustering mitigate the negative effect of poverty on adolescent condom use in South Africa?

Int Fam Plan Perspect. 2008 Sep;34(3):121-6. doi: 10.1363/ifpp.34.121.08.


Context: It is important to examine whether youth from disadvantaged households are less likely than others to use a condom at first sex, even after correcting for shared characteristics within communities.

Methods: Baseline survey data from the Transitions to Adulthood in the Context of AIDS in South Africa study in KwaZulu-Natal were used. Random effects logistic regression assessed the relationship between poverty and 14-22-year-olds' use of condoms at first sex, correcting for shared characteristics of adolescents within each community.

Results: Twenty-three percent of young people had used a condom at first sex. Poor and extremely poor females had about one-third the odds of nonpoor females of using a condom at first sex, even after adjusting for community clustering; among males; however, there was no association between poverty and condom use, after adjusting for background factors and community clustering.

Conclusions: The importance of community clustering of neighborhood-level characteristics differs by gender in South Africa. Poverty remains a central risk factor for HIV among young women, regardless of the surrounding context, but not among men.

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Adult
  • Cluster Analysis
  • Condoms / economics
  • Condoms / statistics & numerical data*
  • Data Collection
  • Female
  • HIV Infections / economics
  • HIV Infections / prevention & control
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Interviews as Topic
  • Logistic Models
  • Male
  • Odds Ratio
  • Poverty*
  • Residence Characteristics
  • Risk Factors
  • Sexual Behavior / ethnology
  • Sexual Behavior / statistics & numerical data*
  • Socioeconomic Factors
  • South Africa
  • Young Adult