Exploring the religious and sociocultural challenges to condom use in the prevention of HIV and unintended pregnancies among married and cohabitating couples in rural Ghana

Abstract

Background: Condom use continues to be the most important strategy for effectively preventing the spread of HIV and STDs. In sub-Saharan African nations with high rates of HIV infection, Condom advocacy initiatives mainly targeted young and single adults, typically under 25 years old Sales et al. (2006); (Sales & DiClemente, 2010). Despite the successes in promoting condoms in controlling the spread of HIV among the above groups, its promotion and use among married and cohabitating couples have been overlooked (Kaiser et al., 2011). Consequently, the prevalence of HIV transmission is rising among married and cohabitating couples in high-prevalence areas like Sub-Saharan Africa, including Ghana. Condom use in marital relationships can be an important tool in the fight against HIV/AIDS and unwanted births; however, there is uncertainty over how married and cohabitating couples would be willing to accept its use (Anglewicz & Clark, 2013). However, the reasons for the unacceptability of condom use for STI and pregnancy prevention in marriage and long-distance relationships could be attributed to sociocultural and religious factors. Objectives of the study: The study aimed to explore how married and cohabitating individuals of religious conviction in rural Ghana negotiate between their religious faith and condom use to prevent HIV and unintended pregnancies. The study further sought to explore the barriers to condom use in preventing HIV transmission and unintended pregnancies among married individuals and the strategies to encourage condom use among married and cohabitating individuals. Data materials and methods: A qualitative phenomenological research study was adopted to explore how married individuals in rural Ghana negotiate between their health safety concerns and their religious faith and the barriers to condom use among married and cohabitating individuals. Nine interviews were conducted via Zoom. The purposive sampling technique was used to recruit research participants who had knowledge and experience in the topic. The researcher analysed the data using Braun and Clarke's (2022) Reflexive Thematic Analysis. Findings of the study: The findings of the study revealed that married and cohabitating individuals face multiple social, religious, and personal challenges in their attempt to use condoms to prevent HIV transmission and unintended pregnancies. Among these barriers include societal stigma and negative interpretation of condom users, perceived body reactions, religious devotion and reproduction, etc. The findings also revealed that participants adopt a pragmatic approach to condom use and alternative paths for pregnancy prevention, among others. The findings also revealed that promoting condom accessibility, branding and privacy packaging, and joint counselling for reproductive health education and awareness by religious leaders are among the strategies to encourage condom use among married and cohabitating individuals. Conclusion: The study explored how married and cohabitating individuals of religious convictions in rural Ghana negotiate between their health safety concerns and religious faiths. The data was collected digitally via Zoom meeting, where the participants shared their personal experiences and perceptions of condom use in their marital relationships. Braun and Clarke’s (2006) Reflective Thematic Analysis Model was used to analyse the data. Different themes of barriers facing married and cohabitating couples in rural Ghana to prevent HIV and unintended pregnancies were explored, as well as strategies to encourage condom use among married and cohabitating individuals