Condom use by South African construction workers

Consistent and proper condom use is pivotal in preventing HIV infection. HIV prevalence in South Africa is among the highest in the world, with the construction industry especially affected, yet little is known about condom use by construction workers and the determinants thereof. Data were gathered from 512 site-based workers in the Western Cape. A theoretical model explaining condom use as a function of demographic factors, HIV knowledge, substance usage and risky sexual behaviour (excluding condom use) was proposed and tested using regression and structural equations modelling. The findings indicated that age, gender and level of education were indirect determinants of condom use, with higher levels of education predicting better AIDS-related knowledge. Higher levels of risky sexual behaviour were associated with more frequent use of condoms, suggesting greater awareness of risk. Condom use was adversely affected by greater alcohol and drug use, probably as a result of diminished capacity to assess risk. Finally, lower and not higher levels of AIDS-related knowledge were associated with better condom use, suggesting that improved knowledge of HIV transmission may work contrary to safe sex practice if it lulls the person into a false sense of confidence. Recommendations for targeted workplace interventions are proposed.