Prevalence and Determinants of Condom Non‐Use During Last Sexual Encounter Among Unmarried Women of Reproductive Age in Tanzania: Findings From a National Survey

Abstract

Background: Condoms are central to preventing sexually transmitted infections (STIs) and unintended pregnancies. Despite awareness, use remains suboptimal among women in Tanzania. This study assessed prevalence and determinants of condom non-use during the last sexual encounter among unmarried, sexually active women using nationally representative data. Methods: We conducted a cross-sectional analytical study using data from the 2022 Tanzania Demographic and Health Survey (TDHS). A total of 2146 unmarried and sexually active women aged 15-49 years were included. The primary outcome was self-reported condom non-use during the last sexual encounter. Descriptive statistics and log-binomial regression were used to identify factors associated with condom non-use, adjusting for sociodemographic variables and survey weights. Results: The prevalence of condom non-use during the last sexual encounter was 19.07%. Regional variation was noted, with the highest prevalence in the Lake zone (4.85%) and the lowest in Zanzibar (0.13%). After adjustment, secondary or higher education was associated with lower odds of condom non-use (aRR = 0.61; 95% confidence interval [CI]: 0.38-0.97), as was having multiple sexual partners (aRR = 0.39; 95% CI: 0.20-0.76). Conversely, women with two or more children had increased odds of non-use (aRR = 2.12; 95% CI: 1.26-3.56). Conclusion: Condom non-use among unmarried women remains a significant public health concern in Tanzania. Education, parity, and sexual behavior patterns are key determinants. Interventions should prioritize comprehensive sexuality education, empower women in reproductive decision-making, and address sociocultural barriers that hinder condom negotiation and use.