Factors Associated with Condom Use Among HIV-Positive Adolescents in Eastern Uganda

Abstract

Benjamin Betunga,1 Lilian Nuwabaine,2 Joseph Kawuki3 1Tororo General Hospital, Tororo, Uganda; 2Africa Health Sciences University, Kigali, Rwanda; 3Department of Family, Population & Preventive Medicine, Stony Brook University, New York, Patchogue, USACorrespondence: Benjamin Betunga, Email benjaminbetunga24@gmail.comBackground: Adolescents increasingly contribute to the global HIV epidemic, and the low HIV testing rates heighten transmission risks. Condom use is crucial in preventing HIV transmission and drug-resistant strains, yet its consistency among HIV-positive adolescents on antiretroviral therapy (ART) remains uncertain. This study investigates the prevalence of condom use and predictors among HIV-positive adolescents attending ART clinic in Uganda.Methods: A cross-sectional study was conducted from January to March 2025 among 165 HIV-positive adolescents (aged 10– 19 years) at Tororo General Hospital ART clinic. Structured questionnaires were used for data collection, and multivariable logistic regression was used to determine predictors of condom use, using SPSS version 27.Results: Condom use prevalence was low at 10.9% among HIV-positive adolescents. On multivariable logistic regression, significant predictors of condom use included urban residence (aOR 2.67, 95% CI: 1.42– 4.98), older age (15– 19 years) (aOR 1.48, 95% CI: 1.12– 2.36), secondary education (aOR 1.31, 95% CI: 1.02– 2.62), Muslim religion (aOR 3.76, 95% CI: 1.98– 6.75), having three or more sexual partners (aOR 2.17, 95% CI: 1.14– 3.87), being on ART for more than five years (aOR 3.73, 95% CI: 1.15– 6.21), and drug use (aOR 1.37, 95% CI: 1.16– 2.11). Nearly all participants (99.4%) reported lack of access to free condoms, while 75.8% had never received counseling on condom use.Conclusion: Condom use among HIV-positive adolescents in Tororo district remains alarmingly suboptimal. Enhancing access to condoms, integrating targeted sexual health education, and addressing sociocultural barriers through community-based interventions are critical. Future research should explore tailored strategies to improve condom adherence in this population.Keywords: adolescents, anti-retroviral therapy, condom use