Condom Use Among Internal Migrant Girls in Ghana: Exploring the Barriers, Enablers, and Willingness to Use Among Sexually Active <i>Kayayei</i>

ABSTRACT Introduction Internal migrant girls, known as Kayayei , are among Ghana's most vulnerable urban populations, facing elevated sexual health risks due to economic insecurity and limited access to reproductive services. Guided by the Health Belief Model (HBM), this study examined barriers, enablers, and willingness to use condoms among sexually active Kayayei . Methods A mixed‐methods design was employed. Quantitative data were collected from 400 Kayayei using structured questionnaires, complemented by 40 in‐depth interviews (IDIs), two focus group discussions (FGDs) with 24 participants, and 20 key informant interviews (KIIs) involving market leaders, Kayayei association representatives, and child protection officers. Quantitative data were analysed descriptively, and qualitative data underwent thematic analysis. Results Only 25.5% of Kayayei reported condom use, while 74.5% did not, indicating low and inconsistent usage. Barriers included partner resistance, limited access, stigma, low self‐efficacy, and misconceptions about condom safety. Enablers comprised peer influence, prior sexual health education, and access to youth‐friendly services. Most expressed willingness to use condoms if freely available. Conclusions Condom use among Kayayei is shaped by psychological and structural determinants. Interventions combining behavioural change communication with economic and social support are vital to increase condom uptake and improve sexual health outcomes among Ghana's internal migrant girls.