{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T03:06:42Z","timestamp":1784084802127,"version":"3.55.0"},"reference-count":35,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"unspecified","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,6,8]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Male condoms are widely available and cost-effective; in recent years, pre-exposure prophylaxis (PrEP), a biomedical prevention choice, has gained more recognition. Recognising that heterosexual men are often under-represented in HIV-prevention research, this study examines trends and factors of condom use among Tanzanian men aged 1549 before and after PrEP rollout, using three Tanzania Demographic and Health Surveys (TDHS) (2010, 2015\/2016, 2022).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a secondary analysis of mens datasets from the TDHS for the years 2010 (N=1858), 2015\/16 (N=2728) and 2022 (N=4337), yielding a combined weighted sample of 8925 men. The primary outcome was self-reported condom use during last sexual intercourse with the most recent partner. Multivariable logistic regression models were used to examine associations between condom use and sociodemographic, behavioural and HIV prevention-related factors. Analysis was stratified by survey year to capture temporal trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, reported condom use declined from 22.2% in 2010 to 20.3% in 2015\/2016 and further to 18.5% in 2022. Higher odds of condom use were associated with secondary education in 2010 (adjusted OR (AOR)=2.12; 95% CI 1.03 to 4.33) and with primary (AOR=2.21; 95% CI 1.34 to 3.64) and higher education (AOR=2.79; 95% CI 1.63 to 4.76) in 2022. Media exposure was also positively associated with condom use, including newspaper exposure in 2010 (AOR=2.18; 95% CI 1.48 to 3.20), television (AOR=1.38; 95% CI 1.38 to 2.48) and newspaper (AOR=1.53; 95% CI 1.02 to 2.31) in 2015\/2016, and radio (AOR=1.33; 95% CI 1.01 to 1.76) and newspaper (AOR=1.41; 95% CI 1.04 to 1.91) in 2022. In 2022, richer (AOR=1.63; 95% CI 1.01 to 2.63) and richest men (AOR=1.74; 95% CI 1.04 to 2.92), never-married men (AOR=2.01; 95% CI 1.31 to 3.07) and those approving daily PrEP use (AOR=1.42; 95% CI 1.01 to 2.00) had higher odds of condom use, while divorced\/widowed men had lower odds across all survey waves. The spatial analysis revealed variations in condom use over time, with some urban areas showing a decline post-PrEP introduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Condom use among men in Tanzania has steadily declined over the past decade after the introduction of PrEP. Targeted interventions are needed to reinforce condom use alongside PrEP to sustain comprehensive HIV prevention efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-004365","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T03:01:23Z","timestamp":1784084483000},"page":"e004365","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Trends and factors associated with condom use among Tanzanian men before and after introduction of pre-exposure prophylaxis: evidence from TDHS 20102022 Tanzania Demographic and Health Surveys"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2649-6556","authenticated-orcid":false,"given":"Magreth Thadei","family":"Mwakilasa","sequence":"first","affiliation":[{"name":"Department of Medical Botany, Plant Breeding and Agronomy, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siri A","family":"Abihud","sequence":"additional","affiliation":[{"name":"Department of Medical Botany, Plant Breeding and Agronomy, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Mwijage","sequence":"additional","affiliation":[{"name":"Department of Medical Botany, Plant Breeding and Agronomy, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0483-1720","authenticated-orcid":false,"given":"Pankras","family":"Luoga","sequence":"additional","affiliation":[{"name":"Department of Development Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"2026071406101728000_4.3.e004365.1","unstructured":"UNAIDS JUNP on H (UNAIDS) . The urgency of now: AIDS at a crossroads, 2024. Available: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/2024-unaids-global-aids-update_en.pdf"},{"key":"2026071406101728000_4.3.e004365.2","unstructured":"WHO . Populations. 2025. Available: https:\/\/www.who.int\/teams\/global-hiv-hepatitis-and-stis-programmes\/populations"},{"key":"2026071406101728000_4.3.e004365.3","unstructured":"UNFPA, WHO and UNAIDS . Position statement on condoms and the prevention of HIV, other sexually transmitted infections and unintended pregnancy, 2025. Available: https:\/\/www.unaids.org\/en\/resources\/presscentre\/featurestories\/2015\/july\/20150702_condoms_prevention"},{"key":"2026071406101728000_4.3.e004365.4","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.bpobgyn.2019.12.001","article-title":"Male and female condoms: Their key role in pregnancy and STI\/HIV prevention","volume":"66","author":"Beksinska","year":"2020","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"2026071406101728000_4.3.e004365.5","unstructured":"Alaei K , Paynter CA , Juan S-C , et al . Using PrEP, losing condoms? PrEP promotion may undermine safe sex. AIDS 2016."},{"key":"2026071406101728000_4.3.e004365.6","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-018-2299-7"},{"key":"2026071406101728000_4.3.e004365.7","doi-asserted-by":"crossref","first-page":"21744","DOI":"10.7448\/IAS.20.1.21744","article-title":"When are declines in condom use while using PrEP a concern? Modelling insights from a Hillbrow, South Africa case study","volume":"20","author":"Grant","year":"2017","journal-title":"J Int AIDS Soc"},{"key":"2026071406101728000_4.3.e004365.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12978-023-01563-6","article-title":"Stigma of infidelity associated with condom use explains low rates of condom uptake: qualitative data from Uganda and Tanzania","volume":"20","author":"Broderick","year":"2023","journal-title":"Reprod Health"},{"key":"2026071406101728000_4.3.e004365.9","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1007\/BF03404075","article-title":"The impact of embarrassment on condom purchase behaviour","volume":"89","author":"Dahl","year":"1998","journal-title":"Can J Public Health"},{"key":"2026071406101728000_4.3.e004365.10","unstructured":"NACP . Implementation framework for pre- exposure prophylaxis of HIV in Tanzania Mainland. Dodoma: National AIDS Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, 2021."},{"key":"2026071406101728000_4.3.e004365.11","unstructured":"NACP . Prevention of new HIV infection  NACP-National AIDS Control Programme, 2023. Available: https:\/\/nacp.go.tz\/prevention-of-new-hiv-infection\/"},{"key":"2026071406101728000_4.3.e004365.12","unstructured":"TACAIDS TC for A . National Multisectoral Strategic Framework for HIV 2021\/22  2025\/26 (NMSF V), 2022. Available: https:\/\/www.tacaids.go.tz\/uploads\/documents\/en-1676620457-NMSF%20V%202021-2026.pdf"},{"key":"2026071406101728000_4.3.e004365.13","unstructured":"TACAIDS TC for A . National HIV Prevention Road Map 2023\/24- 2026\/27. 2024. 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Tanzania Demographic and Health Surveys (TDHS) 2010, 201516, and 2022 datasets. DHS Program; 20112023, 2025. Available: https:\/\/dhsprogram.com\/data\/dataset_admin\/login_main.cfm"},{"key":"2026071406101728000_4.3.e004365.18","unstructured":"DHS . The DHS Program - Methodology, 2023. Available: https:\/\/dhsprogram.com\/Methodology"},{"key":"2026071406101728000_4.3.e004365.19","unstructured":"PrEP Watch Tanzania . Country overview: Tanzania. 2026. 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