Perceived Risk and Condom Use among Adolescents in SubSaharan Africa: A Latent Class Analysis

Julie A. Cederbaum, Tamika D. Gilreath, Anamika Barman-Adhikari


While studies have examined factors associated with condom use behaviors, few have assessed risk perception and condom use among SSA adolescents. This work sought to fill this gap. Data for this study are derived from the National Survey of Adolescents (2004-2005), a survey of 12-19 year olds in Burkina Faso, Ghana, Malawi, and Uganda. Latent class analysis was conducted. Two risk profiles emerged in the data. Percent of adolescents in the high perceived risk sub-groups ranged from 49.6% - 90.8% and moderate risk from 29.1-83.8%. Those in the high perceived risk class were 2.26 to 5.10 times more likely to report condom use. The findings provide additional information about the factors that influence condom use among adolescents in these four countries. Because an individual’s development is influenced by his/her settings and systems, expanded views of behavior must be included in prevention efforts. (Afr J Reprod Health 2014; 18[4]: 26-33).


Keywords: Condom Use, Knowing Someone with HIV/AIDS, Perceived Risk, Health Belief, sub-Saharan Africa 



Alors que des études ont étudié les facteurs associés aux comportements de l’utilisation du préservatif, il n’y en a que très peu qui ont évalué la perception du risque et l'utilisation du préservatif chez les adolescents d'Afrique subsaharienne. Ce travail a cherché à combler cette lacune. Les données pour cette étude sont tirées de l'Enquête nationale auprès des adolescents (2004-2005), une enquête auprès des adolescents âgés  de 12 à 19 ans au Burkina Faso, au Ghana, au Malawi et en Ouganda. L’analyse de structure latente a été menée. Deux profils de risque sont apparus dans les données. Le pourcentage des adolescents dans les sous-groupes à risque élevé perçus variait de 49,6% - 90,8% et un risque modéré de 29,1 à 83,8%. Ceux de la classe de risque perçu élevé étaient  2.26 à 5.10 fois plus susceptibles de déclarer l'utilisation du préservatif. Les résultats fournissent des informations supplémentaires sur les facteurs qui influencent l'utilisation du préservatif chez les adolescents dans ces quatre pays. Parce que le développement d'un individu est influencé par ses paramètres et ses systèmes, il faut inclure des vues élargies de comportement dans les efforts de prévention. (Afr J Reprod Health 2014; 18[4]: 26-33).


Mots-clés: utilisation du préservatif, connaissance d'une personne atteinte du VIH / sida, risque perçu, croyance à la santé, Afrique sub-saharienne

Full Text:



Bankole, A, Ahmed, FH, Neema, S, Ouedraogo, C, Koyani, S. Knowledge of correct condom use and consistency of use among adolescents in four counties in Sub-Saharan Africa. Afr J Reprod Health. 2007; 11:197-220.

Bankole, A, Biddlecom, A, Guiella, G, Singh, S, Zulu, E. Sexual behavior, knowledge and information sources of very young adolescents in four sub-Saharan African countries. Afr J Reprod Health. 2007; 11:2843.

Biddlecom, AE, Awusabo-Asare, K, Bankole, A. Role of parents in adolescent sexual activity and contraceptive use in four African countries. Int Perspect Sex Reprod Health. 2007; 35:72-81.

Biddlecom, AE, Munthali, A, Singh, S, Woog, V. Adolescents’ views of and preferences for sexual and reproductive health services in Burkina Faso, Ghana, Malawi, and Uganda. Afr J Reprod Health. 2007; 11:99- 110.

Kabiru, CW, Ezeh, A. Factors associated with sexual abstinence among adolescents in four sub-Saharan African countries. Afr J Reprod Health. 2007; 11:111132.

Doyle, AM, Mavedzenge, SN, Plummer, ML, Ross, DA. The sexual behavior of adolescents in sub-Saharan Africa: Patterns and trends from a national survey. Trop Med Int Health. 2012; 17:796-807.

Neema, S, Biddlecom, A, Zulu, E. National survey of adolescents, 2005: Uganda [Computer file]. ICPSR22411-v1. Ann Arbor, MI: Inter-university

Consortium for Political and Social Research

[distributor], 2008-07-24.

Kayiki, SP, Forste, R. HIV/AIDS related knowledge and perceived risk associated with condom use among adolescents in Uganda. Afr J Reprod Health. 2011; 15:57-63.

Kibombo, R, Neema, S, Ahmed, FH. Perceptions of risk to HIV infection among adolescents in Uganda: Are they related to sexual behavior? Afr J Reprod Health.

; 11: 168-181.

Tenkorang, EY, Maticka-Tyndale, E, Rajulton, F. A multi-level analysis of risk perception, poverty and sexual risk-taking among young people in Cape Town, South Africa. Health Place. 2011;17:525-535.

Bankole, A, Singh, S, Woog, V, Wulf, D. Risk and protection: youth and HIV/AIDS in sub-Saharan Africa. New York: The Alan Guttmacher Institute; 2004.

Gupta, N, Mahy, M. Sexual initiation among adolescent girls and boys: Trends and differentials in subSaharan Africa. Arch Sex Behav. 2003;32:41-53. doi: 10.1023/A:1021841312539.

Rosenstock, IM. Health belief model. In Kazdin AE, editor. Encyclopedia of Psychology APA and Oxford Press: Washington, DC; 2000. p. 78-80.

Burkholder, GJ, Harlow, LL, Wachkwich, J. Social stigma, HIV/AIDS knowledge, and sexual risk. J Appl

Biobehav Res. 1999;4:27-44. doi: 10.1111/j.1751-


Ajzen, I, Fishbein, M. Understanding attitudes and predicting social behavior. Upper Saddle River, NJ: Prentice Hall; 1980

MacNeil, JM, Anderson, S. Beyond the dichotomy: linking HIV prevention with care. AIDS. 1998;12:S19-S26.

Anderson, KG, Beutel, AM, Maughan-Brown, B. HIV risk perceptions and first sexual intercourse among youth in Cape Town South Africa. Int Fam Plann Perspect. 2007;33:98-105.

Camlin, C, Chimbwete, C. Does knowing someone with AIDS affect condom use: an analysis from South Africa. AIDS Prev Educ. 2003;15:231-244.

Cederbaum, JA, Marcus, SC, Hutchinson, MK. Impact of knowing someone with HIV/AIDS on parent-child communication and HIV risk behaviors. J HIV/AIDS Prev Child Youth. 2007;8:31-44. doi:


Estrin, D. In Ghana, young men's condom use is linked to lack of barriers, perceived susceptibility to HIV infection. Int Fam Plann Perspect. 1999;25:106-107.

Palekar, R, Pettifor, A, Behets, F, MacPhail, C.

Association between knowing someone who died of AIDS and behavior change among South African youth. AIDS Behav. 2008;12: 903-912. doi: 10.1007/s10461-007-9325-5

Biddlecom, A, Gregory, R, Lloyd, CB, Mensch, BS. Associations between premarital sex and leaving school in four sub-Saharan African countries. Studies

Fam Plann. 2008;39: 337-350. doi: 10.1111/j.1728-


Munthali, A, Zulu, E, Nyovani, M, Moore, AM, Konyani, S, Kaphuka, J, Maluwa-Banda, D. Adolescent sexual and reproductive health in Malawi: Results from the 2004 national survey of adolescents. New York: Guttmacher Institute; 2006.

Lubke, GH, Muthen, B. Investigating population heterogeneity with factor mixture models. Psychol

Methods. 2005;10:21-39. doi: 10.1037/1082-


McCutcheon, A. Latent class analysis. Beverly Hills, CA: Sage; 1987.

Nylund, KL, Asparouhov, T, Muthen, BO. Deciding on the number of classes in latent class analysis and growth mixture modeling: a monte carlo simulation study. Structural Equation Modeling. 2007;14:535-

doi: 10.1080/10705510701575396

Centers for Disease Control and Prevention. Child Development: Early Adolescence [internet]. [cited

November 21, 2011]. Available from: m

Green, EC, Halperin, DT, Nantulya, V, Hogle, JA. Uganda’s HIV prevention success: the role of sexual behavior change and the national response. AIDS

Behav. 2006;10:335-346. doi: 10.1007/s10461-006-


Kaiser Family Foundation. Report documents role of education in HIV prevention efforts in Ghana [internet]. 2009 [cited November 21, 2013]. Available from: http:/// earch


  • There are currently no refbacks.