# Gender differences and factors affecting opinions on condom use and sexual experiences among adolescents in a high teenage pregnancy setting in the Volta Region, Ghana

## TL;DR

The study explores how gender, age, and employment influence adolescents' opinions on condom use and sexual experiences in a high teenage pregnancy area in Ghana.

## Contribution

The study provides new insights into gendered dynamics and socio-economic factors shaping adolescent sexual health perceptions in rural Ghana.

## Key findings

- Adolescent girls are less likely to believe condoms are effective for HIV prevention compared to boys.
- Younger adolescents (10–14 years) are more likely to find purchasing condoms embarrassing.
- Employed adolescents are more likely to find purchasing condoms embarrassing than unemployed ones.

## Abstract

Gender is crucial in understanding the sexual behaviour of adolescents regarding their condom use and sexual experiences. However, not much is known about the role gender plays in adolescents’ opinions on condom use and their sexual experiences and other factors that influence these opinions in high-adolescent pregnancy settings in rural Ghana. This study sought to examine the gendered dynamics and factors that shape the opinions of adolescent girls and boys on condom use and how that affects their sexual experiences in the high teenage pregnancy setting of Adaklu District, in the Volta region of Ghana.

Data for this study were extracted from a larger primary baseline cross-sectional study among 188 adolescents (109 girls and 79 boys) aged 10–19 years in 30 communities. Data from a semi-structured questionnaire were analyzed using a bivariate analysis and binary logistic regression.

The results indicate adolescent girls were less likely (aOR = 0.16, CI 0.06–0.43) to agree to the opinion that condoms are an effective way of preventing HIV compared to boys. Adolescent girls are less likely to agree to the opinion that they have been pressured into sex (aOR = 0.15; CI 0.06–0.39), but have higher odds (aOR = 2.58; CI 1.33–1.64) to agree that purchasing condoms is embarrassing for them compared to males. Regarding age, adolescents 10–14 years are less likely (aOR = 0.43; CI 0.19–0.99) to agree that condoms are an effective in preventing HIV compared to those aged 15–19 years. Adolescents aged 10–14 years had higher odds (aOR = 2.91; CI 1.28–6.63) to agree that purchasing condoms is embarrassing for them to compared to the 15–19 year olds. Employment status of adolescents significantly influences their opinion on condom use, where adolescents who are currently employed are more likely to agree to the opinion that it would be embarrassing for them to go and purchase condoms compared to the unemployed ones.

Gender, age and employment status of adolescents are critical to their sexual and reproductive health and wellbeing, as the study findings show distinct sexual experiences of adolescent boys and girls. These important factors should be considered when formulating sexual and reproductive health policies and programs for adolescents to meet their needs.

The online version contains supplementary material available at 10.1186/s12978-025-01990-7.

Sexual and reproductive health needs and experiences of adolescent boys and girls are different, and these differences influence their ideas and opinions on issues such as condom use and male–female sexual activities. Social constructs associated with the biological identity of adolescents coupled with other individual socio-cultural and economic factors plays a critical role in shaping the opinion of adolescents in settings with high prevalence of teenage pregnancy. However, the role of gender and other factors in influencing adolescents' perceptions of condom use and other sexual experiences has not been adequately explored. This paper, therefore, examines the role of gender and other socio-economic factors that influence the opinions of adolescents on condom use and their heterosexual experiences in a high teenage pregnancy setting in the Volta region of Ghana. The results show that the gender identity of adolescents influences their views on condom use and other sexual experiences. Adolescent girls are more likely to believe that condoms are not effective in the prevention of HIV and are also more likely to consider it embarrassing to go and purchase condoms, when compared to boys. Further, adolescents who are below the age of 15 are more likely to believe that condoms are not effective in preventing HIV and also to consider it embarrassing to purchase condoms compared to those 15 years and above. This highlights the importance of gender stereotyping in shaping opinions of adolescents on condom use and sexual experiences. It also points to the importance of intersectional analysis to understand adolescent behaviours, which can then shape the design of programs and policies to support healthy sexual and reproductive choices for adolescent girls and boys. These perceptions place adolescent girls in a compromising position as far as their sexual and reproductive health is concerned and they are often vulnerable to risky sexual behaviours.

The online version contains supplementary material available at 10.1186/s12978-025-01990-7.