Sexual activity and condom use in Lusaka, Zambia

Context: Condom social marketing is among the AIDS prevention strategies being attempted in Lusaka, Zambia, a country where women generally are of low socioeconomic status relative to men, and where the prevalence of sexually transmitted diseases is high. Methods: The 1996 Lusaka Sexual Behavior and Condom Use Survey gathered data on sexual activity in Lusaka from 806 respondents; multiple regression analysis was performed to identify factors that predicted men's and women's condom use. Results: Most respondents reported that their most recent intercourse was with their marital partner (62% of women and 43% of men) or with a regular partner (20% of women and 23% of men) almost one-quarter of men (24%), however, reported having fast had intercourse with a casual partner. Overall, 17% of women and 24% of men had used a condom at fast intercourse. Multivariate logistic regression analysis found that women whose fast intercourse was with a regular or casual partner rather than a marital partner were significantly more likely (odds ratios 2.8 and 3.1 respectively) to have used a condom, as were those who recalled hearing a social marketing advertising message for condoms (2.8). For men, use of condoms was elevated among those who were younger than 30 (odds ratios, 3.3-3.8), who had an education beyond the secondary level (2.2) and who had easy access to condoms (1.9). Conclusions: Because of gender inequity, programs directed at men are more likely to succeed in encouraging condom use than are those aimed at developing women's skills in negotiating condom use.