Descriptive baseline data at enrollment into a cohort of male factory workers who were tested for HIV serology and monitored for sero-conversion over time, were analysed for condom use. At recruitment, the 1,146 men were asked about their sexual behaviour, history of sexually transmitted diseases (STDs), condom use and circumstances under which condoms were used. HIV seroprevalence in the cohort was 18.2 pc. Self reported use of condoms was low, with only 5 pc of the men reporting using them all the time. Forty four pc reported that they had never used a condom, 11.5 pc tried a condom only once, and 30.5 pc used condoms less than half the time. HIV positive men were more likely (Odds Ratio [OR] = 2.2 95 pc CI: 1.3-3.3) to use condoms than those who tested negative. Men using a condom more than once were younger and had more education (p values < 0.0005). Univariate analysis showed that men with self reported risk factors for HIV infection were more likely to use condoms. Significantly more condom users reported paying for sex, multiple sex partners or (for married men) a girlfriend (p < 0.005). Condom users also more often had a history of genital ulcers, urethral discharge or other STDs. Few married men (24 pc) reported using a condom with their wives. Condom use was more commonly reported with commercial sex workers (44 pc) or other extramarital partners (36 pc). Some risk factors for HIV infection were also present amongst men who reported that they did not use condoms.(ABSTRACT TRUNCATED AT 250 WORDS)
PIP: As part of the Zimbabwe AIDS Prevention Project, condom use and HIV serostatus were determined in 1146 male factory workers. The data were analyzed using SPSS statistical software packaged. The student's t-test was calculated for continuous data, chi-square for categorical variables, and step-wise logistic regression was used to assess the independent predictors of condom use in a multivariate model. 18.2% of the men tested positive for HIV, 5% reported using condoms all of the time, 44.1% had never used them, 11.5% had used them once, 30.5% used them occasionally, and 9.1% used them more than half of the time. Whereas, the HIV-positive men reported more condom use overall, only 3.4% reported consistent use. Ever-use of a condom was more common among men who were younger, had more education, or were single. 48% of men who paid for sex used a condom, and 63% of those who admitted having "girlfriends" reported ever using a condom with them. Married men with girlfriends or who paid for sex were much more likely to use a condom for extramarital sex than with their wives. Significantly more condom users had a history of sexually transmitted disease, reported paying for sex, had multiple sex partners, and had an extramarital relationship. The 4 independent significant determinants of condom use revealed by stepwise logistic regression analysis of all variables (controlling for education and HIV status) were younger age, having a girlfriend, number of sex partners in the past year, and cash payment for sex in the past year. These data point to the need for public health campaigns to promote consistent condom use both within and outside of marriage.