title: Determinants of condom use by men in extramarital relationships in Nigeria.
abstract: BACKGROUND
  Extramarital sex is a high-risk behavior in terms of Human Immunodeficiency Virus (HIV) transmission, yet condom use in extramarital relationships is an understudied area in Africa, and Nigeria in particular, where such liaisons are not uncommon. This study highlights key determinants of condom use among men who engage in extramarital sex in Nigeria.
  
  
  METHODS
  Results are based on a subsample of 642 married men from a combined dataset from three waves of the National HIV/AIDS and Reproductive Health Survey (NARHS), a set of multiround nationally representative surveys. Logistic regression was employed to explore possible determinants of condom use in extramarital sex. The motivation, opportunity, and ability model was applied in selecting the determinants.
  
  
  RESULTS
  HIV risk-reduction knowledge was found not to be associated with condom use. At the full logistic regression model, being of the Yoruba tribe, having no misconception about HIV transmission, ability to discuss condom use, and ability to wear condoms were the key variables significantly associated with condom use in extramarital sex.
  
  
  CONCLUSIONS
  Implementing HIV risk-reduction behavior change requires more than knowledge. Behavioral skills in condom use are critical. Intervention efforts should move away from knowledge about risk to concentrate on improving skills on how to discuss condom use and wear condoms correctly.
authors.affiliation: Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana.
authors.forename: Augustine
authors.initials: A
authors.lastname: Ankomah
authors.forename: Samson B
authors.initials: SB
authors.lastname: Adebayo
authors.forename: Jennifer
authors.initials: J
authors.lastname: Anyanti
authors.forename: Olaronke
authors.initials: O
authors.lastname: Ladipo
authors.forename: Bright
authors.initials: B
authors.lastname: Ekweremadu
keywords: Nigeria; condom use; extramarital sex; married men; motivation; opportunity