Motivating Factors and Psychosocial Barriers to Condom Use among out-of-School Youths in Dar es Salaam, Tanzania: A Cross Sectional Survey Using the Health Belief Model.

Condoms remain a cost-effective and relatively simple intervention to prevent HIV infection. However, condom use is still very low, particularly among youths aged 15 to 24. 348 individuals (186 males and 162 females) completed a pre-tested questionnaire. Logistic regression analysis was used to identify factors associated with condom use. Out of 348 respondents, 296 (85.0%) were sexually experienced, and 260 (87.8%) reported noncondom use in the past 3 months prior to the study. Among men, noncondom use was independently associated with feeling shy to buy condoms (AOR = 1.16; 95% CI 1.12-1.34), condoms reducing sexual pleasure (AOR = 8.19; 95% CI 3.98-17.01), and HIV is a serious and deadly disease (AOR = 0.36; 95% CI 0.28-0.46). Among women, experiencing forced sex (AOR = 1.16; 95% CI 1.10-2.78), condoms reduce sexual pleasure (AOR = 8.29; 95% CI 3.36-20.73), and inability to convince a partner to use condoms (AOR = 1.14; 95% CI 1.04-1.28) were predictors of noncondom use. In conclusion, sexually active youths in this population practice risky sexual behaviours, with low condom use practices. Strategies to improve condom use should address these psychosocial barriers associated with noncondom use.