Knowledge, Attitudes, and Practices Regarding Female Condom Use among Married Women: A Cross-Sectional Study

Abstract

Background: Female condoms offer dual protection against unintended pregnancy and sexually transmitted infections (STIs), yet their uptake remains low in many developing settings. Understanding the knowledge, attitudes, and practices (KAP) of married women is essential for improving utilisation and informing reproductive health interventions. This study assessed the level of knowledge, attitudes, and practices regarding female condom use among married women attending a tertiary healthcare facility and identified factors influencing their use. Methods: A descriptive cross-sectional study was conducted among 396 married women attending antenatal and outpatient clinics at Abia State University Teaching Hospital, Aba. Participants were selected using systematic random sampling. Data were collected using a structured, interviewer-administered questionnaire covering socio-demographic characteristics, knowledge, attitudes, practices, and barriers to female condom use. Data were analysed using SPSS version 25. Descriptive statistics summarised variables, while chi-square tests, correlation, and logistic regression analyses were used to determine associations and predictors. Statistical significance was set at p < 0.05. Results: Awareness of female condoms was relatively high (72.2%), but only 38.9% of respondents demonstrated good knowledge. Positive attitudes were observed, particularly regarding effectiveness and female autonomy, although concerns about difficulty and reduced pleasure persisted. Utilisation was low, with only 37.6% reporting ever use and 14.4% consistent use. Key barriers included lack of awareness (42.2%), partner refusal (39.9%), and limited availability (35.1%). Facilitators included awareness campaigns (53.5%) and health worker recommendations (50.0%). Significant associations were found between knowledge, education, age, spousal support, and female condom use. Logistic regression identified good knowledge (OR = 2.36), positive attitude (OR = 2.91), spousal support (OR = 3.27), and awareness exposure (OR = 2.18) as significant predictors of use. Conclusion: Despite moderate awareness, actual use of female condoms among married women remains low. Improving knowledge, addressing sociocultural barriers, and promoting partner involvement are critical to enhancing uptake.