Limitations
The data for this study came from questions assessed at baseline prior to AGYW’s participation in the Cape Town Young Women’s CoOp, a larger trial examining the efficacy of a young-woman − focused HIV prevention intervention. In the baseline instrument, the assessment period of condom negotiation behaviours was the past 6 months, whereas binge drinking behaviours were measured in the past 30 days. Because this is an analysis of baseline data, it did not take into account life changes or other factors that may contribute to increased binge drinking in the past month, which could have indicated a longer pattern of binge drinking contributing to an unequal power dynamic among AGYW and their boyfriends. Because of the difference in assessment periods of each outcome, direct causality cannot be inferred. Additionally, it is likely that participants who reported binge drinking were also using other drugs or substances that may impact the likelihood of them negotiating condom use.Further, this analysis was limited only to participants who reported having a boyfriend or someone with whom they regularly have sex. Because of the exclusion of AGYW who report casual sex with multiple partners, this analysis does not investigate the nuances of power, empowerment, and ability to negotiate condom use within AGYW’s casual sexual encounters, which may be more frequent and make them at even great risk of HIV. Consequently, it may be important for future research to investigate the impact of binge drinking behaviours on AGYW’s ability to negotiate condom use during casual sex. In addition, most participants reported receiving financial support from their boyfriends when they needed it, and a similar proportion reported high levels of agency and personal power. However, despite our understanding that equitable, supportive relationships may increase young women’s power and agency, AGYW who received financial support still had reduced odds of both frequent condom negotiation and frequent use of condoms during impaired sex. Further research should focus on the nuances of this financial support in a greater sociocultural context. Additionally, this study created a combined variable estimating condom negotiation behaviours for use of both male and female condoms, as very few participants reported female condom negotiation and subsequent use. Previous studies have found that AGYW may feel more empowered to negotiate female condom use as compared with male condom use, which, coupled with men’s comparative willingness to use a female condom instead of a male condom, could be imperative for improving condom use behaviours [