The Relationship Between Body Image Perceptions and Condom Use Outcomes in a Sample of South African Emerging Adults

HIV continues to be a health priority in South Africa. Consistent condom use helps prevent HIV, yet less than half of South African emerging adults use condoms consistently. Cultural beliefs about illnesses (e.g., being thin is perceived to be a sign of HIV infection) suggest that body image perceptions may play a role in emerging adults’ condom use outcomes. We explored the relationships between body image perceptions (i.e., body dissatisfaction, body consciousness) and condom use outcomes (e.g., attitudes, negotiation efficacy, past use) in a sample of South African emerging adults. Participants (n = 379) recruited from university residences completed an anonymous survey. Participants’ mean age was 21.79 years, 54.6% were female, 96.1% identified as Black African, and 73.5% reported primarily speaking IsiZulu. For women, the relationship between body dissatisfaction and condom negotiation efficacy was mediated by body consciousness and condom use attitudes after controlling for BMI, relationship status, and mental health symptoms. Further, the relationship between body dissatisfaction and past condom use was mediated by body consciousness. These results were not significant for men. Findings from this study suggest that integrating messages about body image perceptions into HIV prevention efforts targeting South African emerging adult women may be warranted.