Condom use remains a crucial preventive measure for individuals undergoing antiretroviral therapy (ART) in the fight against HIV/AIDS. This review and meta-analysis aimed to determine the pooled prevalence of condom use and the factors associated with it among people living with HIV/AIDS (PLWHA) on ART in Ethiopia. We conducted systematic searches across various databases, including PubMed, Google Scholar, Embase, and Cochrane Library, to identify relevant research articles. The review followed the PRISMA 2020 guidelines. We included cross-sectional studies from Ethiopia reporting condom use prevalence and associated factors among people living with HIV/AIDS (PLWHA) on antiretroviral therapy (ART). Two authors independently extracted data using a standardized Microsoft Excel format, which was then analyzed in STATA 17. Heterogeneity was assessed using the I² test, and pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated to examine the relationship between determinant factors and condom use. In this study, 1,360 articles were identified from various databases, and twelve were selected for the final systematic review and meta-analysis. The pooled prevalence of condom use was 56% (95% CI: 51, 61). PLWHA who are married less likely to use condom (AOR = 0.40, 95% CI: 0.13, 0.66), urban residence was more likely to use condom (AOR = 2.63, 95% CI: 1.29, 3.97), and HIV status disclosure (AOR = 0.21, 95% CI: 0.12, 0.31) were significantly associated with condom use in Ethiopia. low percentage of respondents indicated that they use condoms. Marital status, urban residence, and receiving counseling about condom use, are associated with a higher probability of condom usage.
