Self-reported Female Condom Use, Perceived Effectiveness, and Reproductive Health Outcomes among Women Attending a Tertiary Hospital in Aba, Nigeria

Abstract

Background: Unintended pregnancies and sexually transmitted infections (STIs) remain important public health concerns among women of reproductive age in Nigeria. The female condom is a dual-protection method intended to reduce the risk of both unintended pregnancy and STIs when used correctly and consistently. However, evidence on women’s self-reported use, perceptions, and reproductive health outcomes associated with female condom use in real-world healthcare settings remains limited. This study assessed self-reported female condom use, perceived effectiveness, and reported pregnancy and STI outcomes among women attending a tertiary healthcare facility in Nigeria. Research Methodology: A hospital-based cross-sectional analytical study was conducted among 396 sexually active women aged 18 years and above at Abia State University Teaching Hospital, Aba, Nigeria. Participants were current or previous users of female condoms and were selected using systematic random sampling. Data were collected using a structured, pre-tested questionnaire covering socio-demographic characteristics, reproductive history, female condom use practices, perceived effectiveness, and self-reported unintended pregnancy and STI outcomes. Descriptive and inferential analyses, including chi-square tests, correlation analysis, and logistic regression, were performed using SPSS version 25, with statistical significance set at p < 0.05. Results: Among the respondents, 42.2% reported a history of unintended pregnancy, while 23.7% reported a previous STI diagnosis. During reported periods of female condom use, 81.6% of respondents stated that they had not experienced an unintended pregnancy, and 86.9% stated that they had not experienced an STI. These findings represent self-reported outcomes among current or previous female condom users and should not be interpreted as direct clinical or epidemiological estimates of contraceptive or STI-prevention effectiveness. Most respondents perceived female condoms as effective in preventing pregnancy (62.1%) and STIs (67.7%). Factors associated with reported effective use included higher education (OR = 2.41, p = 0.001), prior training (OR = 3.12, p < 0.001), partner support (OR = 2.87, p < 0.001), availability (OR = 2.23, p = 0.002), and higher income (OR = 1.64, p = 0.041). Positive correlations were observed between knowledge and correct use (r = 0.62), and between partner support and consistent use (r = 0.67). Conclusion: The study found favorable perceptions of female condoms and self-reported associations between education, training, partner support, availability, income, and reported correct or consistent use. However, because the study was cross-sectional and relied on self-reported data, it cannot establish the actual effectiveness of female condoms in preventing unintended pregnancy or STIs. Future prospective studies using verified pregnancy and STI outcomes, clearly defined exposure periods, and appropriate comparison groups are needed to more accurately assess effectiveness. Strengthening health education, improving access, reducing cost barriers, and encouraging partner-inclusive interventions may help promote correct and consistent female condom use among women in Nigeria.