Ghana’s Youth and the Decline in Condom Use: A Cause for Concerning Ghana

, evidence shows that many young people are not consistently using condoms despite awareness of their protective benefits. This shift or non-use raises serious questions for sexual and reproductive health in the country.What the data showA recent analysis of the 2017/18 Ghana Multiple Indicator Cluster Survey found that 79% of young women and 68% of young men did not use a condom during their last sexual intercourse. A study of young adults (15-24 years) using 2014 data found that only about 11% reported consistent condom use. Among senior high school students, only around 36.7% of sexually active students reported using a condom in one study. Other studies show attitudinal barriers: for example, girls are more likely than boys to agree that buying condoms is embarrassing, or that condoms are not very effective. Knowledge is relatively high (many know about condoms) but usage and negotiation of use remain low. Why are condoms not being used (or used consistently)?Several inter-linked reasons appear from research in Ghana: Perceived reduction in sexual pleasure: Some youth believe condoms reduce enjoyment of sex, thereby acting as a barrier. For example one study in Mankranso found respondents strongly agreed “use of condom does not make sex enjoyable.” Embarrassment, stigma and gender norms: For adolescent girls, purchasing or carrying condoms can be seen as “promiscuous.” Girls were more likely to feel condoms are not effective and more likely to feel embarrassed to buy them. Many young people report they couldn’t insist on condom use if their partner didn’t want one. Low self-efficacy and negotiation power: Young people may lack confidence to suggest or insist on condom use, especially in unequal relationships. A study of young men found that perceived barriers and low self-efficacy significantly reduced condom use. Cultural and social beliefs: Some beliefs around fertility, sexual “naturalness,” or mistrust of modern contraceptives create negative attitudes toward condoms. For example, in one community study, adolescents strongly agreed that a girl using contraception before first birth could lead to fertility problems. Access and availability issues, and cost or convenience: Although Ghana has many condoms available; youth friendly access remains a challenge in some settings or the option still carries stigma. Relationships and trust: In “steady” relationships some young people feel condoms are not necessary because they trust the partner or they want to show trust by not using a barrier. While I did not find a direct Ghanaian quote saying “it doesn’t feel natural,” the idea of condoms reducing “naturalness” or spontaneity is hinted in research around “pleasure” and “barrier” perceptions (e.g., the study about enjoyment).ConsequencesThe low rate of condom use among youth has important implications:Increased risk of unintended pregnancies among adolescents. For example, one recent report shows refusal to use condoms is behind 70% of adolescent pregnancies in Ghana. Increased risk of sexually transmitted infections (STIs) including HIV among young people especially when multiple partners or transactional sex are involved. Potential social and economic consequences: adolescent pregnancy affects schooling, employment; STIs carry health burdens; reduced ability to negotiate safe sex may perpetuate gender inequalities.Does the “it’s not natural” angle hold?While I did not locate a major published Ghanaian study where the central explanation from youth was that “condoms are not used because sex should feel natural” in those exact words, multiple studies do reference perceptions of reduced pleasure and the idea that condoms interfere with “the experience.”For example: “The main contraceptive device observed … was condom (10%). Most of them… strongly agreed … use of condom does not make sex enjoyable.”This suggests that the idea of condoms dampening the “natural feel” of sex is part of the discourse. Moreover, the attitudinal barrier of “embarrassment,” “lack of control”or“barrier to spontaneity” points toward a broader cultural perception that safe-sex measures conflict with the ideal of unencumbered intimacy or masculinity/femininity.Policy and programme considerationsGiven this situation, several steps could help improve condom use among Ghana’s youth: Comprehensive Sexuality Education (CSE) that not only gives facts, but builds skills: negotiation, self-efficacy, challenging norms of masculinity/femininity, and addressing peer pressure.Youth-friendly condom access and distribution, in settings where stigma is minimized: e.g., vending machines, free distribution at youth centers, integration with non-sexual-health youth services.Addressing pleasure, spontaneity and barrier narratives: programmes might work to reposition condoms as compatible with pleasurable sex, with correct fit, quality, variant types, lubrication, etc. to reduce “it kills the feel” perception.Engaging both sexes: Many programmes focus on girls; but engaging young men, their attitudes toward condom use, their peer norms around “masculinity,” and how they make decisions in relationships is key. The study in Volta region highlights gendered differences: girls feeling less able to purchase condoms, more embarrassed. Parent, community and peer engagement: Because attitudes are socially embedded, interventions at community level, parental communication, and peer-led activities can help shift norms around safe sex.Monitoring and research: More qualitative work on how youth perceive condoms, pleasure, spontaneity, “natural” sex, as well as pilots of interventions that address those barriers.Addressing structural factors: e.g., poverty, gender inequality, sexual coercion, which reduce young people’s bargaining power in sexual relationships (and thus ability to insist on condom use).ConclusionIn Ghana, a large proportion of young people engage in sexual activity without consistent condom use. The reasons are complex and include perceptions around reduced pleasure, embarrassment, low negotiation power, cultural norms, and structural inequities. While the framing “condom use is dropping because it’s not like natural sex” may not yet be fully documented in precisely that language, the underlying idea that safe-sex practice is seen by many youth as interfering with spontaneous, enjoyable sex is clearly present in the literature.Addressing this challenge will require more than distributing condoms: it will require shifting attitudes, improving skills, creating supportive environments, and ensuring youth feel empowered to make safer choices without feeling that their intimacy is compromised. Mustapha Bature Sallama

Medical/Science communicator ,Private Investigator, Criminal Investigation and Criminal Analysis

International Conflict management and Peace Building. Alumni Gandhi-King Global Academy

United State Institute of Peace Building USIP