Condom Use at Last Sexual Intercourse and Its Correlates among Males and Females Aged 15–49 Years in Nepal
Abstract
:1. Introduction
2. Methods
2.1. Study Area, Study Design, and Sampling
2.2. Measurement of Variables
2.2.1. Condom Use
2.2.2. Explanatory Variables
2.3. Data Analysis Methods
2.4. Ethical Approval
3. Results
4. Discussion
4.1. Limitation of the Study
4.2. Implication of the Study
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
Appendix A
Number of Questions | Questions Asked | Coding |
---|---|---|
1 | Have you heard of about other infections that can be transmitted through sexual contact (STI)? | Yes = 1 No = 0 |
2 | Have you ever heard of an illness called AIDS? | Yes = 1 No = 0 |
3 | Can people reduce their chances of acquiring the AIDS virus by having just one uninfected sex partner who has no other sex partners? | Yes = 1 No/Do not know = 0 |
4 | Can people reduce their chances of acquiring the AIDS virus by using a condom every time they have sex? | Yes = 1 No/Do not know = 0 |
5 | Can people acquire the AIDS virus from mosquito bites? | No = 1 Yes/Do not know = 0 |
6 | Is it possible for a healthy looking person to have the AIDS virus? | Yes = 1 No/Do not know = 0 |
7 | Can one get HIV by sharing food with a person who has AIDS? | No = 1 Yes/Do not know = 0 |
8 | Can HIV be transmitted from a mother to her baby during delivery? | Yes = 1 No/Do not know = 0 |
9 | Can HIV be transmitted from a mother to her baby by breastfeeding? | Yes = 1 No/Do not know = 0 |
10 | Are there any special drugs that a doctor or nurse can give to a woman infected with the AIDS virus to reduce the risk of transmission to the baby? | Yes = 1 No/Do not know = 0 |
References
- Wellings, K.; Collumbien, M.; Slaymaker, E.; Singh, S.; Hodges, Z.; Patel, D.; Bajos, N. Sexual behaviour in context: A global perspective. Lancet 2006, 368, 1706–1728. [Google Scholar] [CrossRef]
- Pinkerton, S.D.; Abramson, P.R. Effectiveness of condoms in preventing HIV transmission. Soc. Sci. Med. 1997, 44, 1303–1312. [Google Scholar] [CrossRef]
- Rodrigo, C.; Rajapakse, S. Current Status of HIV/AIDS in South Asia. J. Glob. Infect. Dis. 2009, 1, 93–101. [Google Scholar] [CrossRef] [PubMed]
- Maharaj, P.; Cleland, J. Condom use within marital and cohabiting partnerships in KwaZulu-Natal, South Africa. Stud. Fam. Plan. 2004, 35, 116–124. [Google Scholar] [CrossRef]
- Kingbo, M.H.K.A. Association of Socio Demographic Characteristics with Condom Used at Last Sexual Intercourse among Adults 15 to 49 Years between Côte D’Ivoire and Senegal an Examination of Measure Demographic Health Survey Data 2005. Master’s Thesis, Georgia State University, Atlanta, Georgia, 2013. Available online: http://scholarworks.gsu.edu/iph_theses/275 (accessed on 2 June 2017).
- Marak, B.; Bhatnagar, T. Sexual behaviours and condom use among young urban women in a town in northeast India: Implications for prevention and control of sexually transmitted infections. Clin. Epidemiol. Glob. Health 2015, 3, S43–S48. [Google Scholar] [CrossRef]
- Chimbindi, N.Z.; McGrath, N.; Herbst, K.; San Tint, K.; Newell, M.L. Socio-Demographic Determinants of Condom Use Among Sexually Active Young Adults in Rural KwaZulu-Natal, South Africa. Open AIDS J. 2010, 4, 88–95. [Google Scholar] [CrossRef] [PubMed]
- Hendriksen, E.S.; Pettifor, A.; Lee, S.J.; Coates, T.J.; Rees, H.V. Predictors of condom use among young adults in South Africa: The Reproductive Health and HIV Research Unit National Youth Survey. Am. J. Public Health 2007, 97, 1241–1248. [Google Scholar] [CrossRef] [PubMed]
- Malema, B.W. Determinants of Condom use in Botswana: An empirical Investigation of the Role of Gender. Botsw. J. Econ. 2012, 10, 59–78. [Google Scholar]
- Agha, S. Factors associated with HIV testing and condom use in Mozambique: Implications for programs. Reprod. Health 2012, 9, 20. [Google Scholar] [CrossRef] [PubMed]
- Nnedu, O.N.; McCorvey, S.; Campbell-Forrester, S.; Chang, J.; Salihu, H.M.; Jolly, P.E. Factors Influencing Condom Use among Sexually Transmitted Infection Clinic Patients in Montego Bay, Jamaica. Open Reprod. Sci. J. 2008, 1, 45–50. [Google Scholar] [CrossRef] [PubMed]
- Calazans, G.; Araujo, T.W.; Venturi, G.; Ivan França, J. Factors associated with condom use among youth aged 15–24 years in Brazil in 2003. AIDS 2005, 19, S42–S50. [Google Scholar] [CrossRef] [PubMed]
- Dahal, S.; Pokharel, P.K.; Yadav, B.K. Sexual Behaviour and Perceived Risk of HIV/AIDS among Returnee Labour Migrants from Overseas in Nepal. Health Sci. J. 2013, 7, 218–228. [Google Scholar]
- Regmi, P.; Simkhada, P.; Van Teijlingen, E.R. Sexual and reproductive health status among young peoples in Nepal: Opportunities and barriers for sexual health education and services utilization. Kathmandu Univ. Med. J. 2008, 6, 248–256. [Google Scholar]
- Puri, M.; Cleland, J. Sexual behavior and perceived risk of HIV/AIDS among young migrant factory workers in Nepal. J. Adolesc. Health 2006, 38, 237–246. [Google Scholar] [CrossRef] [PubMed]
- Acharya, D.R.; Regmi, P.; Simkhada, P.; Van Teijlingen, E. Modernization and Changes in Attitudes towards Sex and Relationships in Young People; Social Science Baha: Kathmandu, Nepal, 2015; pp. 63–94. [Google Scholar]
- Upreti, D.; Regmi, P.; Pant, P.; Simkhada, P. Young people’s knowledge, attitude, and behaviour on STI/HIV/AIDS in the context of Nepal: A systematic review. Kathmandu Univ. Med. J. 2009, 7, 383–391. [Google Scholar] [CrossRef]
- Adhikari, R.; Tamang, J. Premarital sexual behavior among male college students of Kathmandu, Nepal. BMC Public Health 2009, 9, 241. [Google Scholar] [CrossRef] [PubMed]
- Bhatta, D.N. Shadow of domestic violence and extramarital sex cohesive with spousal communication among males in Nepal. Reprod. Health 2014, 11, 44. [Google Scholar] [CrossRef] [PubMed]
- Thapa, S.; Thapa, D.K.; Buve, A.; Hannes, K.; Nepal, C.; Mathei, C. HIV-Related Risk Behaviors Among Labor Migrants, Their Wives and the General Population in Nepal. J. Community Health 2017, 42, 260–268. [Google Scholar] [CrossRef] [PubMed]
- Karki, S. HIV/AIDS Situation in Nepal: Transition to Women. Master’s Thesis, Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden, 2008. [Google Scholar]
- Meekers, D.; Silva, M.; Klein, M. Determinants of condom use among youth in Madagascar. J. Biosoc. Sci. 2006, 38, 365–380. [Google Scholar] [CrossRef] [PubMed]
- Bhattacharya, G. Sociocultural and behavioral contexts of condom use in heterosexual married couples in India: Challenges to the HIV prevention program. Health Educ. Behav. 2004, 31, 101–117. [Google Scholar] [CrossRef] [PubMed]
- Department of Health Service. Annual Report, Department of Health Service, 2015/2016; Government of Nepal, Ministry of Health: Kathmandu, Nepal, 2016.
- World Health Organization. A Conceptual Framework for Action on the Social Determinants of Health; World Health Organization: Geneva, Switzerland, 2010; Available online: http://www.who.int/sdhconference/resources/ConceptualframeworkforactiononSDH_eng.pdf (accessed on 19 October 2017).
- Smith-Estelle, A.; Gruskin, S. Vulnerability to HIV/STIs among rural women from migrant communities in Nepal: A health and human rights framework. Reprod. Health Matters 2003, 11, 142–151. [Google Scholar] [CrossRef]
- UNDP (United Nations Development Program). Human Development Report 2015. 2015. Available online: http://hdr.undp.org/sites/default/files/2015_human_development_report.pdf (accessed on 20 October 2017).
- Measure DHS: Demographic and Health Surveys. Available online: http://www.measuredhs (accessed on 2 April 2017).
- Nepal Demographic and Health Survey 2011; Ministry of Health and Population (MoHP): Kathmandu, Nepal; New ERA and ICF International: Calverton, MD, USA, 2012. Available online: http://dhsprogram.com/pubs/pdf/FR257/FR257%5B13April2012%5D.pdf (accessed on 7 October 2017).
- Karkee, R.; Lee, A.H.; Khanal, V. Need factors for utilization of institutional delivery services in Nepal: An analysis from Nepal Demographic and Health Survey, 2011. BMJ Open 2014, 4, e004372. [Google Scholar] [CrossRef] [PubMed]
- Rutstein, S.O.; Johnson, K. The DHS Wealth Index; DHS Comparative Reports No. 6; ORC Macro: Calverton, MD, USA, 2004. [Google Scholar]
- Yaya, S.; Bishwajit, G.; Danhoundo, G.; Seydou, I. Extent of Knowledge about HIV and its Determinants among Men in Bangladesh. Front. Public Health 2016, 4, 246. [Google Scholar] [CrossRef] [PubMed]
- Khanal, V.; Adhikari, M.; Karkee, R.; Gavidia, T. Factors associated with the utilization of postnatal care services among the mothers of Nepal: Analysis of Nepal demographic and health survey 2011. BMC Women Health 2014, 14, 19. [Google Scholar] [CrossRef] [PubMed]
- West, B.T. Statistical and methodological issues in the analysis of complex sample survey data: Practical guidance for trauma researchers. J. Trauma. Stress 2008, 21, 440–447. [Google Scholar] [CrossRef] [PubMed]
- Adhikari, R. Are Nepali students at risk of HIV? A cross-sectional study of condom use at first sexual intercourse among college students in Kathmandu. J. Int. AIDS Soc. 2010, 13, 7. [Google Scholar] [CrossRef] [PubMed]
- Sogarwal, R.; Bachani, D. Awareness of women about STDs, HIV/AIDS and condom use in India: Lessons for preventive programmes. Health Popul. Perspect. Issues 2010, 32, 148–158. [Google Scholar]
- Dahal, G.P.; Padmadas, S.S.; Hinde, P.A. Fertility-limiting behavior and contraceptive choice among men in Nepal. Int. Fam. Plan. Perspect. 2008, 34, 6–14. [Google Scholar] [CrossRef] [PubMed]
- Regmi, P.R.; Simkhada, P.; Van Teijlingen, E. “Boys Remain Prestigious, Girls Become Prostitutes”: Socio-Cultural Context of Relationships and Sex among Young People in Nepal. Glob. J. Health Sci. 2010, 2, 60. [Google Scholar] [CrossRef]
- Subba, T. Women’s Vulnerability to HIV Risk: Decision Making on Condom Use among Migrant Spouses. Master’s Thesis, University of Eastern Finland, Kuopio, Finland, 2017. [Google Scholar]
- Ghimire, L.; Smith, W.C.S.; van Teijlingen, E.R.; Dahal, R.; Luitel, N.P. Reasons for non-use of condoms and self-efficacy among female sex workers: A qualitative study in Nepal. BMC Women Health 2011, 11, 42. [Google Scholar] [CrossRef] [PubMed]
- Bam, K.; Thapa, R.; Newman, M.S.; Bhatt, L.P.; Bhatta, S.K. Sexual behavior and condom use among seasonal Dalit migrant laborers to India from Far West, Nepal: A qualitative study. PLoS ONE 2013, 8, e74903. [Google Scholar] [CrossRef] [PubMed]
- Poudel, K.C.; Okumura, J.; Sherchand, J.B.; Jimba, M.; Murakami, I.; Wakai, S. Mumbai disease in far western Nepal: HIV infection and syphilis among male migrant-returnees and non-migrants. Trop. Med. Int. Health 2003, 8, 933–939. [Google Scholar] [CrossRef] [PubMed]
- Vaidya, N.K.; Wu, J. HIV epidemic in Far-Western Nepal: Effect of seasonal labor migration to India. BMC Public Health 2011, 11, 310. [Google Scholar] [CrossRef] [PubMed]
Variables | Number | Percentage/Mean# | |
---|---|---|---|
Sex | Male | 3017 | 23.4 |
Female | 9843 | 76.6 | |
Age group (in years) | 15–24 | 3151 | 24.9 |
25–29 | 2494 | 19.1 | |
30–34 | 2142 | 16.8 | |
35–39 | 2068 | 15.9 | |
40–49 | 3005 | 23.3 | |
Ethnicity | Lower caste | 1812 | 14.6 |
Others caste | 5846 | 50.9 | |
Uppers caste | 5202 | 34.5 | |
Religion | Others | 802 | 7.0 |
Buddha | 1064 | 8.4 | |
Hindu | 10,994 | 84.6 | |
Current marital Status | Others | 790 | 6.1 |
Married | 12070 | 93.9 | |
Education | No education | 5167 | 41.1 |
Primary | 2559 | 20.0 | |
Secondary | 4030 | 30.9 | |
Higher | 1104 | 8.0 | |
Occupation | Did not work | 2167 | 18.4 |
Skilled/unskilled manual | 1368 | 10.7 | |
Agriculture | 6803 | 52.6 | |
Service * | 2522 | 18.3 | |
Wealth quintile | Poorest | 2565 | 17.0 |
Poorer | 2334 | 18.7 | |
Middle | 2399 | 21.0 | |
Richer | 2540 | 21.3 | |
Richest | 3022 | 21.9 | |
Ecological region | Mountain | 2094 | 6.5 |
Hill | 5000 | 39.8 | |
Terai | 5766 | 53.7 | |
Development region | Eastern | 2971 | 23.6 |
Central | 3065 | 33.9 | |
Western | 2292 | 20.6 | |
Mid-western | 2445 | 12.2 | |
Far-western | 2087 | 9.6 | |
Type of residence | Urban | 3639 | 14.0 |
Rural | 9221 | 86.0 | |
Mobility | No | 7826 | 60.2 |
Yes | 1821 | 14.0 | |
Missing | 3360 | 25.8 | |
Multiple sexual partners ** | Yes | 1627 | 12.3 |
HIV knowledge Score | Mean | 11,009 | 7.5 |
Age at first sex | Mean | 12,756 | 17.8 |
Missing | 1851 | 16.8 | |
Condom use *** | No | 10,193 | 79.5 |
Yes | 1106 | 7.6 | |
Missing | 1561 | 12.9 |
Variables | Categories | Total Sample (N = 11,299) | Unmarried Sample (N = 284) | ||||||
---|---|---|---|---|---|---|---|---|---|
n | %# | χ2 Value | p Value | n | %# | χ2 Value | p Value | ||
Gender | Male | 2837 | 16.3 | 268.67 | <0.001 | 245 | 68.3 | 30.23 | 0.000 |
Female | 8462 | 6.2 | 39 | 20.9 | |||||
Age group (in years) | 15–24 | 2780 | 14.0 | 182.55 | <0.001 | 215 | 69.1 | NA | NA |
25–29 | 2187 | 9.8 | 39 | 61.6 | |||||
30–34 | 1907 | 7.9 | 15 | 30.3 | |||||
35–39 | 1817 | 7.0 | 6 | 41.7 | |||||
40–49 | 2608 | 4.0 | 9 | 0.0 | |||||
Ethnicity | Lower caste | 1593 | 4.2 | 75.77 | <0.001 | 32 | 53.2 | 1.59 | 0.581 |
Others caste | 5084 | 8.3 | 146 | 64.4 | |||||
Uppers caste | 4622 | 11.3 | 106 | 62.6 | |||||
Religion | Others | 680 | 7.6 | 1.54 | 0.764 | 24 | 62.3 | 0.207 | 0.930 |
Buddha | 876 | 8.7 | 31 | 66.7 | |||||
Hindu | 9743 | 8.9 | 229 | 61.9 | |||||
Marital status | Others | 284 | 62.3 | 1084.91 | <0.001 | NA | NA | NA | NA |
Married | 11,015 | 7.3 | NA | NA | |||||
Education | No schooling | 4428 | 3.2 | 614.72 | <0.001 | 25 | 19.8 | 41.68 | <.001 |
Primary | 2259 | 5.3 | 34 | 35.9 | |||||
Secondary | 3590 | 13.9 | 145 | 73.2 | |||||
Higher | 1022 | 24.3 | 80 | 70.7 | |||||
Occupation | Did not work | 1911 | 10.0 | 216.76 | <0.001 | 64 | 63.4 | 14.08 | <0.008 |
Manual | 1225 | 9.8 | 50 | 58.5 | |||||
Agriculture | 5870 | 5.5 | 70 | 46.0 | |||||
Service * | 2293 | 15.8 | 100 | 74.4 | |||||
Wealth quintile | Poorest | 2243 | 4.3 | 258.43 | <0.001 | 28 | 39.5 | 18.84 | 0.006 |
Poorer | 2047 | 5.7 | 45 | 47.5 | |||||
Middle | 2093 | 6.6 | 47 | 57.9 | |||||
Richer | 2189 | 9.4 | 62 | 80.3 | |||||
Richest | 2727 | 16.1 | 102 | 64.8 | |||||
Ecological region | Mountain | 1872 | 5.9 | 18.491 | 0.018 | 36 | 52.9 | 0.715 | 0.597 |
Hill | 4347 | 10.0 | 112 | 61.3 | |||||
Terai | 5080 | 8.2 | 136 | 64.0 | |||||
Development region | Eastern | 2515 | 8.2 | 50.406 | 0.001 | 63 | 72.8 | 10.04 | 0.058 |
Central | 2751 | 7.3 | 72 | 58.1 | |||||
Western | 1936 | 8.8 | 60 | 63.4 | |||||
Mid-western | 2215 | 9.5 | 53 | 43.8 | |||||
Far-western | 1882 | 14.0 | 36 | 73.5 | |||||
Type of residence | Rural | 8043 | 7.7 | 93.80 | <0.001 | 182 | 62.0 | 0.070 | 0.068 |
Urban | 3256 | 15.0 | 102 | 63.9 | |||||
Mobility | No | 6604 | 8.8 | 22.99 | <0.001 | 149 | 61.3 | 0.902 | 0.389 |
Yes | 1568 | 12.7 | 91 | 67.4 | |||||
Multiple sexual partners | No | 9779 | 7.9 | 72.85 | <0.001 | 137 | 60.6 | 0.342 | 0.621 |
Yes | 1520 | 14.6 | 147 | 63.9 |
Factors | Variables | Adjusted OR (95% CIs) | ||||
---|---|---|---|---|---|---|
Model 1 | Model 2 | Model 3 | Model 4 | |||
Community factors | Ecological region | p = 0.011 | p = 0.147 | p = 0.099 | p = 0.037 | |
Mountain | 1 | 1 | 1 | 1 | ||
Hill | 1.89 (1.24–2.87) | 1.58 (0.96–2.59) | 148 (0.85–2.58) | 1.54 (0.88–2.69) | ||
Terai | 1.70 (1.11–2.62) | 1.30 (0.78–2.16) | 1.04 (0.58–1.87) | 1.01 (0.55–1.82) | ||
Development region | p = 0.027 | p < 0.001 | p < 0.001 | p < 0.001 | ||
Eastern | 1 | 1 | 1 | 1 | ||
Central | 0.74 (0.48–1.15) | 0.75 (0.47–1.19) | 0.81 (0.48–1.38) | 0.82 (0.48–1.40) | ||
Western | 1.06 (0.68–1.67) | 1.07 (0.66–1.72) | 1.48 (0.86–2.54) | 1.55 (0.88–2.73) | ||
Mid-Western | 1.08 (0.67–1.74) | 1.44 (0.84–2.49) | 1.53 (0.82–2.85) | 1.63 (0.87–3.06) | ||
Far-Western | 1.61 (0.94–2.76) | 2.57 (1.46–4.52) | 3.77 (2.08–6.82) | 4.28 (2.31–7.93) | ||
Type of residence | p < 0.001 | p = 0.109 | p = 0.679 | p = 0.823 | ||
Rural | 1 | 1 | 1 | 1 | ||
Urban | 1.98 (1.50–2.61) | 1.33 (0.93–1.91) | 1.08 (0.73–1.60) | 0.95 (0.64–1.41) | ||
Sociodemographic factors | Age group (in years) | p < 0.001 | p < 0.001 | p < 0.001 | ||
15–24 | 1 | 1 | 1 | |||
25–29 | 0.67 (0.45–0.99) | 0.52 (0.33–0.81) | 0.50 (0.32–0.80) | |||
30–34 | 0.47 (0.29–0.75) | 0.45 (0.26–0.76) | 0.45 (0.26–0.77) | |||
35–39 | 0.53 (0.34–0.81) | 0.43 (0.26–0.70) | 0.44 (0.27–0.72) | |||
40–49 | 0.32 (0.20–0.51) | 0.27 (0.15–0.50) | 0.26 (0.14–0.48) | |||
Ethnicity | p = 0.092 | p = 0.197 | p = 0.215 | |||
Lower caste | 1 | 1 | 1 | |||
Others | 1.56 (0.94–2.59) | 1.60 (0.92–2.77) | 1.57 (0.90–2.72) | |||
Upper caste | 1.75 (1.05–2.92) | 1.64 (0.93–2.90) | 1.63 (0.92–2.89) | |||
Religion | p = 0.945 | p = 0.774 | p = 0.527 | |||
Others | 1 | 1 | 1 | |||
Buddha | 1.14 (0.50–2.61) | 1.13 (0.46–2.76) | 1.17 (0.47–2.92) | |||
Hindu | 1.09 (0.60–1.98) | 0.92 (0.47–1.80) | 0.85 (0.44–1.66) | |||
Marital status | p < 0.001 | p < 0.001 | p < 0.001 | |||
Married | 1 | 1 | 1 | |||
Others | 10.71 (7.28–15.77) | 11.88 (7.67–18.36) | 12.88 (8.27–20.05) | |||
Education | p = 0.007 | p = 0.116 | p = 0.178 | |||
No schooling | 1 | 1 | 1 | |||
Primary | 0.77 (0.39–1.50) | 0.81 (0.36–1.83) | 0.99 (0.41–2.39) | |||
Secondary | 1.49 (0.85–2.61) | 1. 50 (0.73–3.09) | 1. 67 (0.77–3.63) | |||
Higher | 1.74 (0.94–3.20) | 1.30 (0.60–2.83) | 1.39 (0.60–3.19) | |||
Occupation | p = 0.638 | p = 0.650 | p = 0.826 | |||
Did not work | 1 | 1 | 1 | |||
Manual | 0.70 (0.31–1.56) | 0.78 (0.30–2.03) | 0.76 (0.29–2.00) | |||
Agriculture | 0.66 (0.29–1.50) | 0.60 (0.22–1.64) | 0.67 (0.24–1.87) | |||
Service * | 0.80 (0.36–1.79) | 0.78 (0.30–2.04) | 0.81 (0.31–2.15) | |||
Wealth quintile | p = 0.003 | p = 0.001 | p < 0.001 | |||
Poorest | 1 | 1 | 1 | |||
Poorer | 0.74 (0.43–1.27) | 0.64 (0.33–1.22) | 0.74 (0.39–1.41) | |||
Middle | 1.18 (0.67–2.08) | 1.09 (0.54–2.20) | 1.28 (0.65–2.52) | |||
Richer | 1.50 (0.88–2.55) | 1.68 (0.91–3.10) | 2.10 (1.18–3.74) | |||
Richest | 2.21 (1.19–4.11) | 2.41 (1.15–5.06) | 3.25 (1.59–6.64) | |||
Behavioral factors | Mobility | p = 0.907 | p = 0.566 | |||
No | 1 | 1 | ||||
Yes | 1.02 (0.71–1.45) | 1.11 (0.77–1.60) | ||||
Multiple sex partners | p = 0.743 | p = 0.916 | ||||
No | 1 | 1 | ||||
Yes | 1.05 (0.78–1.41) | 1.01 (0.74–1.38) | ||||
Age at first sex | p = 0.015 | p = 0.009 | ||||
1.07 (1.01–1.14) | 1.08 (1.02–1.15) | |||||
HIV knowledge | HIV knowledge | p = 0.163 | ||||
0.90 (0.79–1.04) | ||||||
Cox and Snell R2 | 0.018 | 0.191 | 0.211 | 0.220 |
Factors | Variables | Adjusted OR (95% CIs) | ||||
---|---|---|---|---|---|---|
Model 1 | Model 2 | Model 3 | Model 4 | |||
Community factors | Ecological region | p = 0.034 | p = 0.003 | p = 0.012 | p = 0.010 | |
Mountain | 1 | 1 | 1 | 1 | ||
Hill | 1.63 (1.08–2.47) | 1.22 (0.81–1.82) | 1.01 (0.65–1.56) | 0.99 (0.63–1.54) | ||
Terai | 1.30 (0.86–1.98) | 0.78 (0.51–1.20) | 0.66 (0.41–1.07) | 0.65 (0.40–1.06) | ||
Development regions | p < 0.001 | p < 0.001 | p < 0.001 | p < 0.001 | ||
Eastern | 1 | 1 | 1 | 1 | ||
Central | 0.83 (0.56–1.23) | 0.80 (0.55–1.15) | 0.96 (0.62–1.49) | 0.87 (0.58–1.31) | ||
Western | 1.02 (0.69–1.53) | 1.02 (0.70–1.49) | 1.09 (0.71–1.67) | 1.05 (0.68–1.62) | ||
Mid-western | 1.34 (0.90–1.99) | 1.92 (1.33–2.78) | 1.99 (1.25–3.14) | 1.91 (1.21–3.01) | ||
Far-western | 2.21 (1.56–3.12) | 3.89 (2.69–5.62) | 4.21 (2.64–6.69) | 3.83 (2.40–6.10) | ||
Type of residence | p < 0.001 | p = 0.330 | p = 0.711 | p = 0.473 | ||
Rural | 1 | 1 | 1 | 1 | ||
Urban | 2.23 (1.75–2.84) | 1.13 (0.88–1.45) | 1.05 (0.80–1.38) | 1.10 (0.83–1.47) | ||
Sociodemographic factors | Age group (in years) | p < 0.001 | p = 0.001 | p = 0.001 | ||
15–24 | 1 | 1 | 1 | |||
25–29 | 0.90 (0.68–1.19) | 0.84 (0.61–1.14) | 0.84 (0.61–1.15) | |||
30–34 | 0.82 (0.60–1.11) | 0.75 (0.52–1.07) | 0.71 (0.49–1.04) | |||
35–39 | 0.68 (0.46–0.99) | 0.65 (0.41–1.03) | 0.65 (0.41–1.03) | |||
40–49 | 0.41 (0.28–0.61) | 0.34 (0.20–0.56) | 0.29 (0.16–0.51) | |||
Ethicality | p = 0.013 | p = 0.149 | p = 0.071 | |||
Lower caste | 1 | 1 | 1 | |||
Others | 1.95 (1.25–2.06) | 1.64 (0.98–2.74) | 1.82 (1.08–3.06) | |||
Upper caste | 1.73 (1.13–2.64) | 1.58 (0.97–2.56) | 1.61 (0.97–2.68) | |||
Religion | p = 0.255 | p=0.124 | p = 0.326 | |||
Other | 1 | 1 | 1 | |||
Buddha | 1.16 (0.59–2.25) | 1.10 (0.54–2.25) | 1.04 (0.48–2.22) | |||
Hindu | 0.82 (0.50–1.33) | 0.71 (0.42–1.22) | 0.76 (0.41–1.41) | |||
Marital status | p = 0.037 | p = 0.132 | p = 0.078 | |||
Married | 1 | 1 | 1 | |||
Others | 2.96 (1.06–8.26) | 2.29 (0.77–6.81) | 2.85 (0.88–9.25) | |||
Education | p < 0.001 | p < 0.001 | p = 0.001 | |||
No schooling | 1 | 1 | 1 | |||
Primary | 1.25 (0.90–1.73) | 1.07 (0.73–1.58) | 1.00 (0.67–1.49) | |||
Secondary | 2.41 (1.71–3.41) | 1.93 (1.30–2.87) | 1.66 (1.14–2.42) | |||
Higher | 3.96 (2.66–5.88) | 2.76 (1.70–4.49) | 2.57 (1.56–4.24) | |||
Occupation | p = 0.833 | p = 0.998 | p = 0.999 | |||
Did not work | 1 | 1 | 1 | |||
Manual | 0. 86 (0.42–1.76) | 0.98 (0.41–2.29) | 0.98 (0.45–2.10) | |||
Agriculture | 0.90 (0.67–1.19) | 0.97 (0.70–1.33) | 1.01 (0.71–1.42) | |||
Service * | 0.88 (0.66–1.17) | 0.98 (0.71–1.36) | 1.01 (0.73–1.41) | |||
Wealth quintile | p < 000 | p < 0.001 | p < 0.001 | |||
Poorest | 1 | 1 | 1 | |||
Poorer | 1.97 (1.31–2.98) | 2.25 (1.43–3.52) | 1.99 (1.27–3.11) | |||
Middle | 2.09 (1.34–3.27) | 2.28 (1.34–3.88) | 2.19 (1.25–3.83) | |||
Richer | 2.61 (1.63–4.18) | 3.20 (1.87–5.46) | 2.83 (1.63–4.90) | |||
Richest | 4.31 (2.55–7.28) | 5.51 (3.09–9.82) | 4.83 (2.63–8.87) | |||
Behavioral factors | Mobility | p = 0.938 | p = 0.989 | |||
No | 1 | 1 | ||||
Yes | 0.98 (0.67–1.42) | 0.99 (0.68–1.45) | ||||
Multiple sex partners | p = 0.908 | p = 0.967 | ||||
No | 1 | 1 | ||||
Yes | 0.95 (0.45–2.03) | 0.98 (0.45–2.11) | ||||
Age at first sex | p = 0.186 | p = 0.229 | ||||
1.03 (0.98–1.07) | 1.02 (0.97–1.07) | |||||
Knowledge | HIV knowledge | p = 0.554 | ||||
1.03 (0.92–1.15) | ||||||
Cox and Snell R2 | 0.012 | 0.053 | 0.055 | 0.054 |
© 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Sharma, B.; Nam, E.W. Condom Use at Last Sexual Intercourse and Its Correlates among Males and Females Aged 15–49 Years in Nepal. Int. J. Environ. Res. Public Health 2018, 15, 535. https://doi.org/10.3390/ijerph15030535
Sharma B, Nam EW. Condom Use at Last Sexual Intercourse and Its Correlates among Males and Females Aged 15–49 Years in Nepal. International Journal of Environmental Research and Public Health. 2018; 15(3):535. https://doi.org/10.3390/ijerph15030535
Chicago/Turabian StyleSharma, Bimala, and Eun Woo Nam. 2018. "Condom Use at Last Sexual Intercourse and Its Correlates among Males and Females Aged 15–49 Years in Nepal" International Journal of Environmental Research and Public Health 15, no. 3: 535. https://doi.org/10.3390/ijerph15030535