Abstract |
Gender norms against adolescent girls and young women (AGYW)’s having pre-marital sex and using condoms in marriage are included as barriers to motivation to use condoms in HIV prevention cascades. Representative survey data on gender norms are needed to test this assumption. General-population survey participants in Manicaland, Zimbabwe (ages>15, N=9803) were asked if they agreed/disagreed with statements on gender norms. AGYW at risk of HIV infection were asked whether community views discouraged condom use. Multivariable logistic regression was used to measure variations in community members’ views and associations between AGYW’s perceiving negative gender norms and condom HIV prevention cascades. 57 percent of men and 70 percent of women disagreed that ‘If I have a teenage daughter and she has sex before marriage, I would be ok with this’; and 41 percent of men and 57 percent of women disagreed that ‘If I have a teenage daughter, I would tell her about condoms’. 32 percent and 69 percent of sexually-active HIV-negative unmarried AGYW, respectively, said negative community views were important in decisions to use condoms and their friends were not using condoms. In each case, those who agreed had lower motivation to use condoms. Fewer of those with friends not using condoms reported using condoms themselves (39 percent vs. 68 percent; p<0.001). 21 percent of men and 32.5 percent of women found condom use in marriage acceptable. 74 percent and 93 percent of married AGYW at risk, respectively, said negative community views influenced their decisions to use condoms and their friends did not use condoms. Fewer married AGYW reporting friends not using condoms were motivated to use condoms but there was no difference in reported condom use (4.1 percent vs. 6.9 percent; p=0.48). Negative gender norms can form a barrier to motivation to use condoms in unmarried and married AGYW at risk of HIV infection, and, for unmarried AGYW, to condom use. |