Determinants of condom use at last sex by South African construction workers

Due to its fragmented nature, the typically remote location of project sites and considerable reliance upon migrant workers, the construction industry in South Africa is adversely affected by the HIV/AIDS pandemic. The correct and consistent use of condoms is critical to combatting the spread of infection and reinfection. The demographic, behavioural and AIDS-related knowledge determinants of condom use at last sexual encounter were investigated in a survey of 512 site-based construction workers in the Western Cape Province. Half of all survey participants reported not having used a condom at last sexual encounter. Respondents most likely to have not used a condom were predominantly ‘Black’ African, single, in the 27 to 36 and 37 to 49 years old age groups, and those engaging in risky sexual behavior. Gender, education, employment position, alcohol consumption and cannabis (‘dagga’) use were not found to be significantly related to condom use, nor was the extent of workers’ AIDS-related knowledge. Workplace interventions by employers (in response to requests by the South African government for greater private sector involvement), whilst focusing on all employees, should concentrate their efforts on identifying and targeting those demographic sub-populations that are at greatest risk for lack of condom use. Particular attention should be given to construction workers who are migratory (rural to urban work-seekers), working on sites in remote areas, or working in environments where the appeal and likelihood of risky sexual behavior are anticipated to be greatest.