A Meta-Analysis of Gender, Marital Status, and Residence on Condom Use Among Adults

Agustin Mahardika Hariyadi; Mentary Febryant Putry; Sita Rahayu Sanusi; Bhisma Murti; Elsa Tursina

doi:10.26911/thejmch.2025.01.02.01

Authors

Agustin Mahardika Hariyadi Master’s Program in Public Health, Universitas Sebelas Maret
Mentary Febryant Putry Master's Program in Public Health, Universitas Sebelas Maret
Sita Rahayu Sanusi Master's Program in Public Health, Universitas Sebelas Maret
Bhisma Murti Master's Program in Public Health, Universitas Sebelas Maret
Elsa Tursina Master's Program in Public Health, Universitas Sebelas Maret

DOI:

https://doi.org/10.26911/thejmch.2025.01.02.01

Abstract

Background: The use of condoms is the only method of contraception that can protect a person from sexually transmitted diseases (STDs). This study aims to analyze and estimate the effect of gender, marital status and residence on condom use among adults.

Subject and Method: The systematic review and meta-analysis studies were conducted according to the PRISMA flowchart and PICO model. Population: Adults in general. Intervention: Gender (Female), Place of Residence (Rural) and Marital Status (Unmarried) in using condoms. Comparison: gender (male), place of residence (urban), and marital status (married). Outcome: condom use. The basic data used involves Google Scholar, PubMed, BMC, Scient Direct, and Springer Link with the keywords (“Use condom”) AND (“Gender”) AND (“Marital status”) AND (“Adult”) AND (“Cross -sectional”). Inclusion criteria were cross-sectional study articles in English published from 2014 to 2024. Data analysis was carried out using the Review Manager 5.3 application.

Result: This meta-analysis included 14 cross-sectional studies from Ethiopia, Iran, Africa, and America. The sample size in this meta-analysis was 18,322. Meta-analysis showed that condom use was less in women (aOR= 0.66; 95% CI= 1.20 to 0.36; p 0.170), and more in rural areas (aOR= 0.80; 95% CI= 0.66 to 0.98; p= 0.620), with unmarried status (aOR = 0.92 CI 95%= 1.97 to 0.43; p 0.830). However, these three results were not statistically significant.

Conclusion: Condom use is less among women and more in rural areas with unmarried status.

Keywords:

adult, gender, marital status, use condom

References

Abera H, Tamiru F, Kibret GD (2017). Intention toward condom use and its associated factors among students of Debre work senior secondary and preparatory school, East Gojam Zone, Amhara region, Ethiopia. Dove medical press. 9:137-143.

Abraha, Amirhossein T, Ali AS, Alireza O (2019) Availability and disparities in access to center-based primary health services in Ethiopia. PLoS ONE 14(3):1-2. Doi: 10.1371/journal.pone.0213896.

Ahmed M, Seid A (2020). Does women’s autonomy matter on attitude towards condom use in reducing risk for HIV infection among married women in Ethiopia. Dove medical press. 12; 489-496.

Ajayi AI, Akpan W (2018) Determinants of condom use among parous women in North Central and South Western Nigeria : a cross ‑ sectional survey. BMC Research Notes, 11(1): 1–6. Doi: 10.1186/s13104-018-3573-5.

Ali MS, Tegegne ET, Tesemma MK, and Tegegne KT (2019) Consistent condom use and associated factors among hiv-positive clients on antiretroviral therapy in North West Ethiopian Health Center. Hindawi, 19(2):1-10. Doi: 10.1155/2019/7134908.

Armoon B, Vleury MJ, Bayani A, Ahounbar E (2022). Inconsisten condom use and risk taking among people who injec drugs in Saveh: Finding from a cross-sectional study in Iran. Sexuality research and socpolicy. 20;993-999.

Bae YS, and Kim DH (2015). A Comparison of the sexual knowledge, attitudes, and behaviors of korean college students studying in Korea and in the United States, OJN, 5(11): 1053–1062. Doi: 10.4236/ojn.2015.511112.

Bandiera O, Niklas B, Robin B, Markus G, Selim G, Imran R, Munshi S (2020). Women's empowerment in action: evidence from a randomized control trial in africa. AEA Journal 12(1):1-65. Doi: 10.125712/app.20170416.

Cislaghi B, Heise L (2020). Gender norms and social norms : differences , similarities and why they matter in prevention science. SHI 42(2):407–422. Available at: Doi: 10.1111/1467-9566.13008.

Dube N, Nkomo TS, and Khosa P (2017). Condom usage negotiation among customarily married women in Katlehong, Johannesburg. SAGE Open Med 7(1):1-7. SAGE Publication Ltd. Doi: 10.1177/2158244016687345.

Elshiekh HF, Hoving C, and De Vries H (2020). Exploring determinants of condom use among university students in Sudan, Archives of Sexual Behavior. PMCID 49(4):1379–1391. Doi: 10.1007/s10508-019-01564-2.

Fladseth K, Gafos M, Newell ML, McGrath N (2015). Dampak norma gender terhadap penggunaan kondom di kalangan orang dewasa HIV-positif di KwaZulu-Natal, Afrika Selatan (The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa). PLoS Satu 10 (4), e0122671.

Gebresilassie F, Ayele B, Hadgu T, Gebretnsae H, Negash D, Demoz GK, Gebru KT, Wubayehu T, and Ricceri F (2023). Predictors of Condom Use Among Youth of the Rural Tigray, Northern Ethiopia. PMCID (15):377-385. Available at: Doi: 102147/HIV.S412337.

Geleta RH, and Mesafint A T (2019). Condom utilization and affecting factors among people living with hiv/aids attending art clinics in Addis Ababa, Ethiopia. HIV/AIDS. PMCID 19(12):583-590. Doi: 10.2147/HIV.S276802.

Gelibo T, Alemayehu A (2015). Consistent condom use and preference of HIV risk preventive interventions among undergraduate university students in Southern Ethiopia: a cross sectional study. J AIDS Clin Res. 6 (4): 442.

Jimu SE, Ntoimo LFC, and Okonofua FE (2023). Prevalence and determinants of condom use among the youth in Malawi: Evidence from the 2015/16 Malawi Demographic. Reproductive Health. PMCID 20(1):1-10. Doi: 10.1186/s12978-023-017149.

Kristin F, Mitzy G, Marie LN, McGratch NM (2015). The Impact of gender norms on condom use among hiv-positive adults in KwaZulu-Natal. PLoS ONE 10

(4):1–19. Doi: 10.1371/journal.pone.0122671.

Liu R, Xu K, Zhang X, Cheng F, Gao L, Jhunfang X (2023). HIV related knowledge and sexual behaviors among teenagers: impclation for public health intervention. children MDPI. 10;1198. doi.org/103390/children10071198.

Masanja V, Wafula ST, Ssekamatte T, Isunju JB, Mugambe RK, Van Hal G (2021). Trends and correlates of sexually transmitted infections among sexually active Ugandan female youths: evidence from three demographic and health surveys. BMC.21(1):59. Doi: 10.1186/s1287902005732x.

Melvin L (2016). Hubungan antara penggunaan kondom dan infeksi virus herpes simpleks (Association between condom use and herpes simplex virus infection). London BMJ 12(4):1-15. Doi: 10.5421/hiv.2016.06.003

Njau B, Mwakalo V, and Mushi D (2013). Correlates of use of condoms among sexually active youth in Southern. SAGE Open. 3(2). A Doi: 10.1177/2158244013491406.

Shamu S, Khupakonke S, Farirai T, Slabbert J, Chidarikire T, Guloba G, Nkhwashu N (2020). Knowledge, attitude and practices of young adults toward HIV prevention: an analysis of baseline data from a community-based HIV prevention intervention study in two high HIV burden districs, South Africa. BMC Public Health. 20;1249. doi.org/10.1186/s12889-020-09356-3.

Stover J, and Teng Y (2022) The impact of condom use on the hiv epidemic, Gates Open Res. 5(91):1-17. Doi: 10.12688/gatesopenres.13278.2.

Tesfaye B, Seifu Y, Tekleselassie B, and Ejeso A (2020). The magnitude and associated factors of consistent condom utilization among art users in Hawassa City , Sidama , Ethiopia. PMCID 12(15):909–922. Doi: 10.2147/HIV.S280143.

Tumwesigye NM, Ingham R, and Holmes D (2017) Condom use at first and latest sexual events among young people : evidence from a rural and peri-urban setting in Uganda. PMCID 13(2):407-14. Doi: 10.4314/ahs.v13i2.30.

William CW, Sealing C, Heidi YH, Jason J, Julie C, Kelley AL (2018) Contextual factors associated with consistent condom use and condom self efficacy amongst African asylum seekers and refugees in Hong Kong. ACIPC. 23 (1):23-32. Doi: 10.1016/j.idh.2017.08.006.

World Health Organization (2016). Sexually transmitted infections. World Health Organization. 11 (7): 1–4.

World Health Organization (2020). Indonesia : gender dan kesehatan (Indonesia: gender and health). World Health Organization.

Yosef T, Nigussie T (2020). Attitude And Practice Toward Condom Use Among Mizan-Aman Polytechnic College Students In Bench Sheko Zone, Southwest Ethiopia. Pharmacophore. 10(2); 122-128.

Yosef T, Nigussie T (2020). Behavioral profiles and attitude toward condom use among college students in Southwest Ethiopia. BioMed Research International. 6. doi.org/10.1155/2020/9582139.