Health Belief Model Applied to Condom Usage in West Africa

HIV has devastated the world in the last 20 years claiming millions of lives.  The majority of these lives are lost in Sub Saharan Africa.  Widespread and freely available information on HIV and AIDS has had no effect on the rising rates of the infection in this area.  The virus is still spreading and rates of condom use remain the same.  One study done in Benin, West Africa looks at condom usage rates. HIV information is freely available in this country, but rates of the disease are still disproportionately high.  The HBM is employed in this study to determine the motivating factors for individual risky behavior. (Hounton et al., 2005).

In 2002, the researchers used a sample of 235 people ages 15-55 years in a cross-sectional survey.  The number of males and females were roughly equal.  Trained social workers provided a World Health Organization (WHO) developed questionnaire to the participants.  Statistical analyses were then completed to identify motivating factors for condom use.

The study used several variables including socio-demographic characteristics, perceived vulnerability, perceived severity of the disease, perceived efficacy, perceived barrier and condom use during the last occasion of sexual intercourse.  The study identified perceived efficacy and perceived barriers as the main HBM components related to condom use in this population.  Therefore a prevention method based on boosting perceived efficacy and lowering perceived barriers is likely to be effective.  Because the other constructs showed no strong relationship to condom use, it is unlikely that a prevention program based on  them will be successful in the population being studied.

Less than two-thirds of this population reported condom use.  Younger single individuals with more education were most likely to report condom use.  Use decreased with age and less education.  While males were slightly more likely to report condom use than females, less than half of both sexes used a condom in their most recent sexual encounter.  Males, single individuals and individuals with more education reported having twice the number of sexual partners in the last 12 months as females.  Age groups did not differ in the number of sexual partners in the last 12 months.

The study participants showed a high perceived risk, high perceived severity, but low perceived efficacy of condom as a protective measure against HIV.  The barriers to condom use include problems using condoms and the harmful beliefs that HIV is physically recognizable or that HIV is not a real disease.  Other barriers include cultural practices such as polygamy, religion, belief in a cure for the disease.

This study provided a great deal of useful information on future prevention programs for HIV in West Africa.  The fact that women showed to have an overall higher level of knowledge of HIV and AIDS shows that education may be helpful to the men in this population.  However, both sexes had sufficient knowledge of the disease and continued to practice risky behaviors.  This shows that education alone is not effective in preventing the spread of HIV.  While women did have a higher level of knowledge, they were less likely to have ever used a condom.  This may be related to women not feeling able to assert their will in sexual situations.

This study sought to explain health behaviors related to HIV. Results indicated that perceived efficacy and perceived barriers should be the focus of future prevention programs in this area.  Other factors had less association with condom use and are less likely to be effective in preventions (Hounton et al., 2005).

Hounton, S.H., Carabin, H. & Henderson, N.J. (2005). Towards an understanding of barriers to    condom use in rural Benin using the   Health Belief Model:  A cross sectional survey. BMC Public Health, 5(8), 1-8. doi:10.1186/1471-2458-5-8


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