Abstract:
Condom promotion remains a key component of HIV prevention programs, complimenting recent
successes in biomedical HIV prevention. Although condom use has increased in much of East Africa, it
remains substantially below optimal levels. Negative rumors about condoms have been documented in
East Africa, yet the prevalence and effects of belief in the negative rumors have not been explored. This
study evaluated levels of belief in negative rumors about condoms, developed a Negative Condom Beliefs
Scale, and assessed its accuracy in predicting willingness to use condoms. A cross-sectional, cluster
survey (n ¼ 370) was conducted representing adults in two rural districts in Northern Tanzania in 2008.
Item agreement ranged from 35 to 53% for the following rumors regarding condoms: causing cancer,
having holes, containing HIV, having worms, and the worms causing HIV. Items loaded on a single latent
factor and had high internal consistency and convergent validity. In a multivariate model, negative
condom score (AOR ¼ 0.67, 95% CI ¼ 0.6, 0.8) was the strongest single predictor of willingness to use
condoms, followed by greater perceived anonymity in acquiring condoms (AOR ¼ 4.36, 95% CI ¼ 2.2, 8.6)
and higher condom self-efficacy (AOR ¼ 4.24, 95% CI ¼ 2.0, 8.9). Our findings indicate high levels of
subscription to negative beliefs about condoms, with two out of three respondents affirming belief in at
least one negative condom rumor. This study highlights the relation between condom rumor beliefs and
willingness to use condoms, and indicates avenues for future research and means for improving the
design of HIV prevention programs.
