Comparing Condom Use with Different Types of Partners: Evidence from National HIV Surveys in Africa

Damien de Walque, World Bank Group
Rachel Kline, World Bank Group

Based on nationally representative samples from 13 sub-Saharan African countries, we reinforce and expand previous findings that men report using condoms more frequently than women and that unmarried individuals report they use condoms more frequently than married individuals with their spouse. Based on descriptive, bivariate, and multivariate analyses, we also demonstrate to a degree not previously shown in the current literature that married men from most countries report using condoms with extramarital partners about as frequently as unmarried men. However, married women from most countries included use condoms with extramarital partners less frequently than unmarried women. This result is especially troubling because marriage usually ensures regular sexual intercourse, providing more opportunities to pass HIV from extramarital partner to spouse than an unmarried person who may also have multiple partners but not as regular sexual intercourse. These findings about high-risk behaviors can be used to better target future prevention efforts.