Using the Theory of Planned Behavior to Predict Intention to Use Condoms Among Male and Female Injecting Drug Users

This study tested the utility of the theory of planned behavior (TPB) for understanding and predicting condom use intentions among male and female injecting drug users (IDUs). Interviews were conducted with 405 male and 315 female sexually active IDUs. Participants indicated their intentions to use condoms with main and nonmain sexual partners as well as attitudes, social norms, partner norms, and perceived behavioral control relevant to condom use with each partner type. The TPB accounted for 36 to 48% of the variance in intentions to use condoms. Intentions were related to attitudes, regardless of partner type. Partner norms were related to intentions to use condoms with main partners (men and women) and nonmain partners (men only). Social norms did not predict intentions, regardless of partner type. Perceived behavioral control was related to intentions to use condoms with main partners (men and women) and nonmain partners (women only). The findings are interpreted in light of the roles of cooperation, intimacy, and concern about self-protection.     

Integration of five health behaviour models: Common strengths and unique contributions to understanding condom use

The purpose of this research was to select from the health belief model (HBM), theories of reasoned action (TRA) and planned behaviour (TPB), information–motivation–behavioural skills model (IMB) and social cognitive theory (SCT) the strongest longitudinal predictors of women's condom use and to combine these constructs into a single integrated model of condom use. The integrated model was evaluated for prediction of condom use among young women who had steady versus casual partners. At Time 1, all constructs of the five models and condom use were assessed in an initial and a replication sample (n?=?193, n?=?161). Condom use reassessed 8 weeks later (Time 2) served as the main outcome. Information from IMB, perceived susceptibility, benefits, and barriers from HBM, self-efficacy and self-evaluative expectancies from SCT, and partner norm and attitudes from TPB served as indirect or direct predictors of condom use. All paths replicated across samples. Direct predictors of behaviour varied with relationship status: self-efficacy significantly predicted condom use for women with casual partners, while attitude and partner norm predicted for those with steady partners. Integrated psychosocial models, rich in constructs and relationships drawn from multiple theories of behaviour, may provide a more complete characterisation of health protective behaviour.     

The prediction of safe sex behaviour: The role of intentions,attitudes, norms and control beliefs

Abstract

The present study was designed to examine the utility of the theory of reasoned action (Fishbein and Azjen, 1975) in relation to people's propensity to engage in a range of different safe sex strategies, including engaging in an exclusive sexual relationship, avoiding casual sex, and asking sexual partners about their previous sexual and IV drug use history. It was proposed that the intention to engage in a particular safe sex practice would be influenced by the person's attitude towards engaging in the practice, as well as his or her perception of the extent to which others thought they should do so (subjective norm), while behavioural intentions were proposed to predict actual behaviour. The study was also designed to examine whether, after control of the effects of the components of the theory of reasoned action, the person's generalised control beliefs would explain any additional variance in either behavioural intentions or actual behaviour. One hundred and two sexually active heterosexual students participated in the study. At the first wave of data collection, subjects completed measures of intentions, attitudes, and norms appropriate to each of the different behaviours. Measures of actual behaviour were obtained at follow-tip (three months after first period of data collection). The results of the study indicated that attitudes and norms predicted intentions for avoiding casual sex and asking sexual partners about their previous sexual and IV drug use history, while intentions predicted actual behaviour for all three safe sex strategies. Although there were no significant main effects of control beliefs on intentions or behaviour, subjects with internal control beliefs were more likely than their counterparts with external control beliefs to behave in accordance with their intentions to engage in an exclusive sexual relationship and ask sexual partners about their previous sexual and IV drug use history. Additional analyses revealed that the levels and determinants of intentions and actual behaviour were, in general, similar for males and females.     

The 90's: gender differences in AIDS-related sexual concerns and behaviors,condom use and subjective condom experiences

To evaluate gender differences in the subjective experience and use of condoms, 193 heterosexual patrons at 13 bars in New York City were interviewed on site in 1991. Most respondents were single, middle class, and White; their ages ranged from 18 to 51 years. The data analysis was restricted to the 155 men and women who had at least 1 new partner in the 3 years preceding the survey. Respondents worried most about acquired immunodeficiency syndrome (AIDS) when engaging in sex with a new partner. 86% indicated concern about AIDS had affected their sexual behavior, most often by increasing their condom use and decreasing casual sex. 91% of women and 79% of men said that condoms give them greater peace of mind. Women worried more than men about AIDS when they had a new sexual partner and were more likely to limit their number of partners, work harder on an existing sexual relationship, give up casual sex, or give up sex with new partners. Men's subjective condom experiences were related to their penile functioning (erection and ejaculation) and the threat of loss of sexual pleasure. Multiple regression equations revealed that, among men, condom use with new partners was associated with worrying about AIDS and younger age; among women, peace of mind was a positive predictor. With casual partners, more partners led to increased condom use among women and worrying about AIDS was a predictor for men; peace of mind was predictive for both genders. 53% of men compared to 21% of women expected to meet a new sexual partner at the bar where they were interviewed, and 36% of men and 19% of women were carrying condoms with them.     

The impact of information about the prevalence of AIDS-Preventive behavior among men and women: The mediating role of social norms

Abstract

The present study was designed to examine the effect of information about the high prevalence of safe sex on condom use intention, and to investigate the possible mediating role of the perceived social norm of friends, and the perceived social norm of future. sexual partners. Participants were provided with gender specific prevalence information, that is with the information that most men have exclusively safe sex, or with the information that most women exclusively engage in safe sexual behavior. The results show some gender differences. Information about the high prevalence of safe sex among men tends to increase women's condom use intention, and this effect seems to be mediated by the paceived social norm of future sexual partners. Men's intention, on the other hand, seems to be unaffected by high prevalence information of safe sex. Implications for research and prevention are discussed     

Safe and Unsafe Sexual Intentions and Behavior: The Effects of Norms and Attitudes1

A study of 85 heterosexual men, 85 heterosexual women, and 82 homosexual men was undertaken to examine the variables that influence intentions to engage in different sexual practices and actual sexual behavior. On the basis of Fishbein and Ajzen's (1975) theory of reasoned action, it was predicted that the strength of intentions would be related to whether behavior was in accord with intentions. Consistent with expectations, the strength of intention to engage in six different sexual practices (e. g., vaginal intercourse, anal intercourse, oral sex) and the three strategies that modify the risk of HIV transmission (sex with an exclusive partner, sex wearing a condom, and looking for a new partner) predicted actual behavior. Second, it was proposed that attitudes toward one's sexual practices and norms would be related to intentions to engage in safe sex. To reflect differential levels in the safety of behavioral intentions, five safety intention groups were formed: (a) nonpenetrative sex, (b) penetrative sex in an exclusive relationship with a condom, (c) penetrative sex in an exclusive relationship without a condom, (d) penetrative sex in a nonexclusive relationship with a condom, and (e) penetrative sex in a nonexclusive relationship without a condom. Norms, rather than attitudes, distinguished the five safety intention groups. the groups intending to engage in safe sex (nonpenetrative sex or penetrative sex with a condom) perceived lower levels of social approval for their sexual practices than the noncondom groups. Additional analyses showed that past behavior had a stabilizing effect on the intention-behavior relationship, but only for the nonpenetrative and noncondom safety intention groups.     

Exploring teenagers' adaptive and maladaptive thinking in relation to the threat of hiv infection

Abstract

Teenagers' HIV-preventive cognitions were explored within a protection motivation theory framework. Five hundred and seven adolescent men and women from two cohorts (sixteen and eighteen) completed a confidential postal questionnaire. The effect of demographic variables, previous sexual experience and appraisal of threat and coping resources upon HIV-relevant cognitions was investigated using path analysis. Cognitions promoting (adaptive) and inhibiting (maladaptive) preventive behaviour were considered. Anticipated condom use, intention to limit number of sexual partners and willingness to consider an HIV antibody test were included as adaptive HIV-preventive cognitions. Coping appraisal measures were strongly associated with anticipated condom use but threat appraisal measures were not. Gender, previous sexual experience, coping appraisal measures and denial accounted for 33% of the variance in anticipated condom use. Overall the results provided qualified support for Protection Motivation Theory. Implications for health education are highlighted.     

The relationship between attitude,assertiveness and condom use

Abstract

This study investigated the relationships between attitudes, assertiveness and intention to use and actual use of condoms as a means of preventing infection from sexually transmitted disease. Both homosexual (n = 83) and heterosexual men (n = 128) participated in the survey. It was found that the homosexual men held more favourable attitudes, and reported greater intended and actdal condom use than the heterosexual men. Intention to use condoms was positively related to favourable attitudes, which were related to condom-specific assertiveness for both groups. For the heterosexual men only, general social assertiveness was negatively related to attitudes toward condoms. It was concluded that condom use was reassuringly frequent among homosexual men, but not for heterosexual men. Efforts to increase condom use among the latter will need to take into account negative attitudes and, in particular, the possible perception of condom use as an effeminate behaviour.     

Predicting high risk sexual behaviour in heterosexual and homosexual men: the roles of impulsivity and sensation seeking

Impulsivity and sexual sensation seeking were examined as personality correlates of high risk sexual behaviour — unprotected sex with multiple partners — in samples of heterosexual (n=112) and homosexual (n=104) men. Among heterosexuals, both personality variables were associated with frequency of unprotected sex but only sexual sensation seeking was associated with number of sex partners. Sexual sensation seeking also mediated the association between use of drugs other than alcohol and number of sex partners. Among homosexuals, no personality or substance use variables predicted high risk sexual behaviour. Implications of the findings for the study of determinants of sexual risk-taking are discussed.     

The relationship between attitude,assertiveness and condom use

The Australian study investigated condom-specific assertiveness and condom use as a means of prevention infection from sexually transmitted diseases. 211 men participated including 83 homosexual men (aged 19-62 years) and 128 heterosexual men (aged 17-49) who completed a questionnaire that comprised demographic details such as age, monogamy, and sexual activity as well as attitudinal and assertiveness measures. General assertiveness was measured by the Rathus Assertiveness Schedule (RAS) which had been widely used across a wide range of social situations. Assertiveness relating specifically to situations involving condoms was measured by the Condom Assertiveness Scale (CAS). Intention to use condoms was positively related to favorable attitudes, which were related to condom-specific assertiveness for both groups. For the heterosexual men only, general social assertiveness was negatively related to attitudes toward condoms. For both groups, the condom-specific measure of assertiveness was positively correlated with attitudes toward condoms. Condom-specific assertiveness was positively related to general social assertiveness as measured by the Rathus Assertiveness Schedule for the homosexual, but not for the heterosexual men. The negative relationship between general assertiveness and attitude to condoms among the heterosexual men implies that the risk reducing behavior of condom use did not seem to accord with the perceptions of masculinity and social assertiveness among heterosexual men. Thus, female partners of such heterosexual men exhibiting negative attitudes toward condom use combined with assertiveness would have to overcome resistance to insist on the use of condoms. Recently some advertising campaigns have been directed at women. The promotion of condom use among heterosexual men has to deal with the perceptions of condom use as unmasculine behavior.     

Intention, Context, and Safe Sex: Australian Adolescents' Responses to AIDS

This study examined the applicability to condom use of Ajzen and Madden's (1986) theory of planned behavior by examining the predictors of intention to use a condom and actual condom use in a specific sexual situation. In a sample of 144 sexually active heterosexual males and females, limited support was found for the model. Intentions to use a condom immediately before a particular sexual encounter, and those assessed some time prior to this encounter were found to have direct and positive effects on condom use. In addition, perceptions of the disadvantages of condoms (a measure of attitudes to condoms in general) had direct negative effects on condom use and, together with perceptions of the advantage of condoms, also had indirect effects on condom use via prior intention. A number of the postulated predictors of safe sexual practice related neither to intentions nor behavior. The contextual variables of sexual arousal, condom availability, and degree of communication with a sexual partner all influenced condom use. Discussion centered on first, differences in the predictive ability of the model when compared to other studies of planned behavior, and second, the factors limiting the relationship between intention and behavior when the behavior in question is not under complete, volitional control.     

Integration of five health behaviour models: common strengths and unique contributions to understanding condom use

The purpose of this research was to select from the health belief model (HBM), theories of reasoned action (TRA) and planned behaviour (TPB), information-motivation-behavioural skills model (IMB) and social cognitive theory (SCT) the strongest longitudinal predictors of women's condom use and to combine these constructs into a single integrated model of condom use. The integrated model was evaluated for prediction of condom use among young women who had steady versus casual partners. At Time 1, all constructs of the five models and condom use were assessed in an initial and a replication sample (n?=?193, n?=?161). Condom use reassessed 8 weeks later (Time 2) served as the main outcome. Information from IMB, perceived susceptibility, benefits, and barriers from HBM, self-efficacy and self-evaluative expectancies from SCT, and partner norm and attitudes from TPB served as indirect or direct predictors of condom use. All paths replicated across samples. Direct predictors of behaviour varied with relationship status: self-efficacy significantly predicted condom use for women with casual partners, while attitude and partner norm predicted for those with steady partners. Integrated psychosocial models, rich in constructs and relationships drawn from multiple theories of behaviour, may provide a more complete characterisation of health protective behaviour.     

Factors Explaining the Intention to Use Condoms Among Injecting Drug Users Participating in a Needle‐Exchange Program1

This study identified the psychosocial factors related to condom‐use intention, based on Triandis’ (1980) theory of interpersonal behavior, among 261 injection drug users participating in a needle‐exchange program. With regular partners (n= 139), condom‐use intention was explained by normative beliefs, self‐efficacy, length of relationship with last regular sexual partner, and taking oral contraceptives. Condom‐use intention with casual partners (n= 157) was also associated with self‐efficacy and normative beliefs, on top of cognitive dimension with attitudes and lending used needles. Neither the perception of being HIV‐positive, nor the habit of using a condom was associated with intention. It is thus suggested that interventions aimed at promoting condom use among this clientele be oriented toward the reinforcement of personal convictions as well as toward the development of competencies needed to overcome obstacles, since both relate to the intention to adopt this behavior.     

HIV‐Related Behaviors Among Prison Inmates: A Theory of Planned Behavior Analysis1

Prison inmates have high prevalence rates for both HIV and AIDS, creating a great need for HIV prevention efforts. We tested the theory of planned behavior (TPB) in 3 domains: intention to engage in condom use when released, intention to not share tattoo equipment in prison, and intention to not share needles or tattoo equipment when released. A total of 478 inmates (87% male) completed TPB and sexual and needle‐use risk behavior measures. TPB constructs accounted for a significant variance in intention to use condoms among African American, Hispanic, and Caucasian inmates, though the strength of the relationships differed by ethnicity. The TPB was less successful for intention to share tattooing equipment and not to share needles or tattoo equipment after release.     

Students' online collaborative intention for group projects: Evidence from an extended version of the theory of planned behaviour

Given the increasing use of web technology for teaching and learning, this study developed and examined an extended version of the theory of planned behaviour (TPB) model, which explained students' intention to collaborate online for their group projects. Results indicated that past experience predicted the three antecedents of intention, while past behaviour was predictive of subjective norm and perceived behavioural control. Moreover, the three antecedents (attitude towards e‐collaboration, subjective norm and perceived behavioural control) were found to significantly predict e‐collaborative intention. This study explored the use of the “remember” type of awareness (i.e. past experience) and evaluated the value of the “know” type of awareness (i.e. past behaviour) in the TPB model.     

Perceived behavioural control,subjective norms,attitudes and intention to use condom: A longitudinal cross-lagged design

Based on the Theory of Planned Behaviour (TPB), the purpose of this investigation was to examine the directionality of the association among condom use, intention, attitudes, subjective norms and perceived behavioural control. The present study investigated the nature of these relationships using a longitudinal cross-lagged design applied to data from a cohort of 958 randomly selected Italian adults. Using structural equation modelling, two cross-lagged panel analyses revealed reciprocal relationships between intention and attitudes and between intention and condom use. Contrary to expectations, baseline subjective norms and perceived behavioural control did not predict subsequent intention to use condom when controlled for the autoregressive effect of intention at T1 on the same variable at T2. Also, perceived behavioural control at T1 did not influence condom use at T2 after controlling for the effect of baseline intention. The possibility of reciprocity was also tested for all relations and significant results were found. The moderation effect of perceived behavioural control on the relationship between intention and condom use was not significant. The differences in age, gender and partnership status were taken into account in the analyses.     

Sexual behaviour,condom use and prediction in attenders at sexually transmitted disease clinics—implications for counselling

A cohort of 260 clinic attenders completed an inventory to examine sexual behaviour, condom use and appraisal and to determine whether situational factors in their last sexual encounters were predictive of condom use. Response to health education compaigns promoting condoms in the light of HIV were also examined. It was found that risk exposure was consistently high. A subsample induldged in anal intercourse, which was unprotected in over two-thirds of instances. Condom uptake was varied Difficulties with condoms were widespread and fell into physical and psychological categories. The only predictor of condom use was the desire for unprotected sex. This data seems to indicate that sex is not a drive out of conscious control, but that individuals weigh up costs and benefits which may be marginally influenced by some situational variables such as alcohol. This has profound implications for counselling which can be aimed at addressing the misconceptions and beliefs that some individuals hold. Such misconceptions may result in risky behaviour which may potentially expose them to HIV. Such understanding is an important prerequisite for effective interventions. Differences between responses for heterosexual and homosexual men and women were examined.     

Bringing up condom use and using condoms with new sexual partners: Intentional or habitual?

Abstract

A prospective study of 94 Dutch adults who have casual sexual partners examined whether two important aspects of safe sex, namely bringing up condom use (BCU) and actual condom use (ACU) are intentional or habitual. For each of these aspects, a model based on the Theory of Planned Behaviour (TPB: Ajzen, 1991) was pitted against a similar model that was extended with a path from past to later BCU and ACU, respectively. The results suggest that bringing up the issue of condom use was equally predicted by intentions and past BCU. However, among people with casual partners, using condoms - and more importantly not using condoms - was especially predicted by past ACU, suggesting a strong habitual component. These results are discussed in terms of their implications for safe sex education and the use of theories in safe sex promotion campaigns.     

Neuroticism,conscientiousness and fruit consumption: Exploring mediator and moderator effects in the theory of planned behaviour

Integrating the theory of planned behaviour (TPB) with the five-factor model (FFM) of personality may provide insight into the cognitive and motivational mechanisms linking personality with health behaviour, but this issue has received very little attention regarding fruit consumption. Mediator effects of TPB concepts in the personality–fruit consumption link, as well as moderator effects of personality in the intention–fruit consumption link, were therefore investigated in the present study. Data on fruit consumption, TPB concepts and FFM dimensions were gathered among 405 respondents in face-to-face interviews using questionnaires. Structural equation modelling was used to investigate the mediator and moderator effects. The direct effect of conscientiousness on fruit consumption was mediated by attitude and perceived behavioural control, while no direct effect of neuroticism on fruit consumption was found. Neuroticism moderated the intention–fruit consumption relationship with the weakest relationship for those scoring high on neuroticism. Conscientiousness did not moderate the intention–fruit consumption relationship. TPB variables are mediators in the conscientiousness–fruit consumption link. Whether fruit consumption is intentional may be dependent upon the personality dimension neuroticism. Personality dimensions may be a useful addition to the TPB and should be considered in health behaviour change interventions.