Consistent condom use with different types of partners: evidence from two Nigerian surveys.

HIV prevalence in Nigeria is increasing rapidly. Increased condom use is the most viable solution to slow down or reverse this trend. This article uses data from two waves of a nation-wide survey, each with over 5,000 respondents, to examine factors that influence consistency of condom use with various types of partners. The results show that while the overall level of consistent condom use has remained low, reported consistent condom use with occasional partners and commercial sex workers exceeds 60%. There is also some evidence of an increasing trend in consistent condom use, even after controlling for differences in sample composition and other factors. The most important factors affecting consistency of condom use are awareness that condoms are effective at preventing HIV and that they are effective at preventing unwanted pregnancy, concern about unwanted pregnancy, and concern about HIV. Although concern about unwanted pregnancy has a strong effect on consistency of condom use with stable partners, concern about HIV infection has a strong effect on consistency of condom use with nonstable partners. The results suggest that HIV prevention programs need to do more than provide education about the modes of transmission and the ways to prevent infection. Improving the effectiveness of HIV prevention programs is likely to require focusing more explicitly on people's personal risk perception and condom efficacy. Focusing on these topics may further accelerate the observed positive trend in condom use.