title: Towards an understanding of barriers to condom use in rural Benin using the Health Belief Model: a cross sectional survey.
abstract: BACKGROUND
  HIV/AIDS is the most dramatic epidemic of the century that has claimed over two decade more than 3 million deaths. Sub Saharan Africa is heavily affected and accounts for nearly 70% of all cases. Despite awareness campaigns, prevention measures and more recently promotion of anti viral regimens, the prevalence of cases and deaths is still rising and the prevalence of systematic condom use remains low, especially in rural areas. This study identifies barriers to condom use based on the Health Belief Model (HBM) in Benin, West Africa.
  
  
  METHODS
  The study was a cross-sectional survey conducted from June to July 2002. Two hundred fifty one (251) individuals were interviewed using a structured questionnaire adapted from a standardized WHO/GAP questionnaire. A logistic regression was used to identify factors associated with condom use.
  
  
  RESULTS
  In spite of satisfactory knowledge on HIV/AIDS transmission, participants are still at high risk of contracting the infection. Sixty three (63) percents of the interviewees reported being able to recognize infected people, and condom use during the last occasional intercourse was declared by only 36.8% of males and 47.5% of females. Based on the HBM, failure to use condom was related to its perceived lack of efficacy [OR = 9.76 (3.71-30.0)] and perceived quality [OR = 3.61 (1.31-9.91)].
  
  
  CONCLUSIONS
  This study identifies perceived efficacy (incomplete protective effect) and perceived utilization-related problem (any reported problem using condoms) as the main barriers to condom use. Hence, preventions strategies based on increasing perceived risk, perceived severity or adequate knowledge about HIV/AIDS may not be sufficient to induce condom use. These data will be useful in designing and improving HIV/AIDS prevention outreach programs in Sub Saharan Africa.
authors.affiliation: Department of HIV/AIDS and Reproductive Health, Centre MURAZ, Bobo-Dioulasso, Burkina Faso. hounton_sennen@yahoo.fr
authors.forename: Sennen H
authors.initials: SH
authors.lastname: Hounton
authors.forename: Hélène
authors.initials: H
authors.lastname: Carabin
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Henderson
mesh_terms: D000293:Adolescent; D000328:Adult; D000354:Africa, Western / Q000453:epidemiology; D001294:Attitude to Health / Q000208:ethnology*; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control*; D015438:Health Behavior / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D021841:Safe Sex / Q000208:ethnology*; D012494:Sampling Studies; D020377:Self Efficacy; D011795:Surveys and Questionnaires