ABSTRACT Background: The vulnerability to HIV and AIDS of school children and youth in general raised the need for school-based prevention programs that encourage safe sexual behaviour. This study was conducted as a part of the Kahe Community Health Development Project in the northern part of Tanzania. Main objective: To describe trends over time (2001-2006) in condom awareness, perceived accessibility and use among school children in Kahe wards, Kilimanjaro region. Methods: Cross-sectional surveys were conducted from 2001 to 2006. A self administered questionnaire was administered to standard six and seven pupils to collect the needed data on demographic characteristics, condom awareness, accessibility and use. Social Science Statistical Package (SPSS IL Inc USA version 14) and Epi Info 6 (CDC) were used for analyses. Results: A total of 4008 pupils were participated from 2001-2006. Condom awareness among primary school pupils rose significantly from 18.1% in 2001 to 33.6% in 2006 (p for trend <0.001). From 2001 to 2006 reported condom use among from sexually active participants rose from 20.5% in 2001 to 27.6% in 2006 (p for trend <0.747). The proportion of participants reporting easy accessibility to condom increased from 9.5% in 2001 to 14.6% in 2006 (p=0.219). While males were more aware about condom and reported more condom use than females in the 2006 survey, females reported to access condoms more easily than did the males. The proportion of females’ participants who knew what condom is increased with increase in age. This pattern was not prevalent among males. Moreover, participants expressed difficulties in using condom when having sexual intercourseConclusion: Despite the fact that condom awareness increased significantly over the survey years, both awareness and use remained low. School-based intervention activities may contribute to this positive impact to the pupils’ awareness on condom, perceived condom accessibility and use. The demonstrated gender difference on condom awareness in our study calls for a need to have different interventions taking into consideration the specific needs of males and females. OPERATIONAL DEFINITIONSThe World Health Organization (WHO) defines young people as those in the age range 10-24 years, comprising both Adolescents (10-19 years) and youth (15-24 years) (1).It is important to note that the Tanzanian educational system employs the following age categorization:Children under 6 years - preschool age 7-14 years - primary school age15-19 years - secondary school age>20 years - college and university ageHowever, in practice the pupils’ ages in this study were found to be out of that range of the stipulated official categories. This is partly due to late school admission resulting from various reasons: Lack of schools where the children stay and parents do not prioritize education in relation to other economic activities that children participate in order to support their families. Possibly some pupils were not sure of their ages. The words “pupils” and “school children” are used interchangeably in this study.In this study a condom refers to male condom which is defined as a device, made of latex, or more recently polyurethane, that is used during sexual intercourse. It is put on the male partner's penis, for the purpose of preventing pregnancy and/or the transmission of sexually transmitted infections (STIs) such as gonorrhea, syphilis and HIV.Awareness: refers to vigilance in observing some things or experience and alertness in drawing inference from what one observes, in this study therefore;Condom awareness: refers to the ability of a student to know what condoms are, whether they have heard about condoms or seen them.Condom accessibility: refers to the ease by which pupils may obtain condoms in their locality.
Perception of condom accessibility: refers to how condom accessibility is thought of, understood and expressed by.In-school youth: refers to youth who attend primary school. Trend: General direction either downward or upward of which variables of interest will take.Self efficacy in condom use: Defined as a degree of confidence a pupil had in their ability to use condom.