Socio-Demographic and Behavioral Determinants of Female Condom Utilization among Women of Reproductive Age, Sagamu LGA, Ogun State, Nigeria

Abstract

Background: Female condoms prevent both unintended pregnancy and sexually transmitted infections (STIs). In Nigeria, usage remains extremely low with only 5.5-8.9% reported using Female condoms. It is on this note that this research aimed to assess the knowledge, attitude and factors inhibiting students towards the utilization of female condoms among students of South Western Nigeria College of Health Technology, Sagamu LGA, Ogun state. Aim: This study employed a cross-sectional design to assess the level of knowledge, attitudes, and utilization of female condoms and to identify factors associated with their use among women of reproductive age. Method: A cross-sectional study was conducted among 288 students from 3 departments selected through a proportionate stratified sampling technique. Data were collected using a self-administered, semi-structured questionnaire incorporating adapted Female Condom Knowledge Scale (FCKS), Condom Attitude Scale (CAS), Condom Use Behaviour Scale (CUBS) and Health Belief Model (HBM) scales. Analysis in IBM SPSS Statistics version 25 involved descriptive statistics, Mean score was used to categorise Knowledge, attitudes and utilization while factors inhibiting the use of female condom was descriptive. Inferential tests using chi-square and multiple linear regression were significant at p < 0.05. Results: The mean age of respondents was 20.7 ± 3.9 years. On a 20 points knowledge scale, 176 (61.1%) had good knowledge, 112 (38.9%) had poor knowledge. On a 28-point attitude scale, 172 (59.7%) had positive attitudes toward female condom use, 116 (40.3%) had negative attitudes. On a 20-point utilisation scale, 172 (59.7%) had poor utilization. Factors influencing female condom use included accessibility, cost, partner influence, health worker/media guidance, self-efficacy, and fear of pregnancy or STIs, shaping utilization. Knowledge was significantly associated with female condom utilization (p = 0.025), whereas attitude showed no significant association (p = 0.505). Regression analysis indicated that knowledge and attitude jointly predicted female condom utilization (p = 0.003). Conclusion: Findings indicate that knowledge was good and attitudes were positive among students, but utilization of female condoms remained low. Also, knowledge significantly predicted usage, yet, female condom use was hampered by accessibility, cost, partner reactions, health messaging, self-efficacy, and fear of pregnancy or STIs, with fear of adverse outcomes being a strong motivator. It is recommended that health education campaigns, improved distribution channels, and partner-inclusive interventions be implemented to promote positive attitudes, and increase consistent female condom use among students.