Condom Use Decision-Making among Male Undergraduate Students of the University of Ghana

Abstract

Background: Sexual health among university students is a major public health concern, with many engaging in risky behaviours that increase their risk of STIs, including HIV. Although condom use is widely promoted, its consistent use remains low owing to social, psychological, and behavioural factors. In Ghana, awareness of condoms’ protective role is high, yet their actual usage is inconsistent, particularly among young men. Factors, such as low perceived STI risk, condom dissatisfaction, and partner dynamics, influence this behaviour. Understanding these influences is crucial for developing targeted interventions. This study examines condom use decision-making among male undergraduates at the University of Ghana. Objective: This research sought to examine the dynamics of condom use decision making among male undergraduate students at the University of Ghana. Methods: A descriptive, quantitative, cross-sectional study was conducted among 435 male undergraduate students residing in halls of residence at the University of Ghana, Legon Campus. Data were collected using structured self-administered questionnaires. Descriptive statistics were used to summarise key variables, and associations between factors influencing condom use decision making were tested using Pearson’s chi-square test and logistic regression analysis with STATA version 18. Results: The study involved 400 male undergraduate students at the University of Ghana, Legon Campus. The prevalence of condom use was 77.08% for the last sex, but only 34.03% reported consistent use. In terms of information accessibility, 71.75% of respondents relied on social media for condom-related information, yet 68.50% had never participated in condom use programs. Regarding motivation, only 24.25% were very motivated to use condoms consistently, and 38.25% were neutral about whether condom use signified responsibility. Regarding behavioural skills, 62.25% had never received condom use training and only 28.75% actively negotiated condom use. While access to information was associated with condom use (COR = 2.0; 95% CI = 1.31 – 3.06; p = 0.001), motivation and behaviour showed no significant association. Conclusion: The study revealed that while condom use during last sex was relatively high (77.08%), consistent use remained low (34.03%). Key factors influencing condom use decision making included access to information, motivation, and behavioural skills. Well-informed students were more likely to use condoms, but motivation and behavioural skills did not show a significant association with consistent use. Barriers, such as reduced pleasure, trust in a partner, and lack of condom negotiation skills, contributed to inconsistent use. Strengthening sexual health education, improving condom accessibility, and enhancing behavioural skill training are essential to promoting safer sexual practices among students