Determinants of condom use as a temporary family planning method among married men in Indonesia : in the era of HIV

Abstract

Condoms are an effective barrier contraceptive method offering a dual role for preventing pregnancy and disease transmission. However, the major focus of condom promotion strategies has been on increasing their use for HIV prevention. This study aimed to determine the factors influencing condom use for family planning purposes among married men in Indonesia. Using the 2007 Indonesia Demographic and Health Survey married men data set, probit logistic regression analysis was conducted for a sample of 895 married men, aged 20- 54, who had ever used a condom, did not use sterilization methods, and wanted no more children. Probit models examined factors influencing the decision for condom use as a contraceptive method among married men in general, and preference for condom use as a method of choice among married men who were contraceptive users. Path analysis was performed to test the hypothesized model that specifies relationships between all observed variables. This study revealed that the low rate of condom use in Indonesia is significantly due to a lack of knowledge about family planning, low understanding on condom-specific knowledge and negative attitudes towards condom use. The study findings also revealed that knowledge of STDs had an indirect effect on condom use, through attitudes in favor of condom use among married men in general. Both HIV/AIDS and STDs knowledge had indirect effects on condom use through an attitude in favor of condom use among married men who already were contraceptive users. Moreover, barriers to condom use had both direct and indirect effects to decrease condom use. In addition, having had experience paying for sex with female sex workers significantly reduced use of condoms. The findings suggest that policy implications should focus on promoting condom use at two levels. First, at community level, by emphasizing providing family planning knowledge and knowledge of STDs, to increase contraceptive use including condom use. Second, at the clinic level among married men who already are c