Predictors of Condom Use in Mexican Migrant Laborers

The purpose of this study was to explore predictors of condom use with occasional sex partners and regular sex partners, as well as carrying condoms in a new high-risk group for HIV infection, Mexican migrant laborers. This study extends previous findings by (1) exploring additional predictors not previously examined, (2) utilizing a large sample of male and female Mexican migrant laborers, (3) carefully controlling for the effects of various demographic and lifestyle variables related to condom use, and (4) assessing the interactive effects of gender on predictors of condom use. Snowball sampling was used to survey 501 adult Mexican migrant laborers. Results revealed that condom use with occasional sex partners was predicted by carrying condoms and condom self-efficacy and that women were more likely to use condoms with occasional partners when both men and women knew someone with HIV/AIDS. Condom use with regular sex partners was predicted by procondom social norms, less negative attitudes toward condoms, not knowing someone with HIV/AIDS, and condom self-efficacy. Carrying condoms was predicted by procondom social norms, less negative attitudes toward condoms, condom self-efficacy, worry about contracting HIV/AIDS, and women were more likely than men to carry condoms when both men and women were married. Understanding these findings, future research directions, and implications for condom promotion strategies with Mexican migrant laborers are discussed.     

A six-month follow-up of adolescents' sexual risk-taking,HIV/AIDS knowledge,and attitudes to condoms

A follow-up study was conducted to investigate change in sexual behaviour, knowledge about HIV/AIDS transmission, and attitudes to condoms over a 6-month period in a sample of late-adolescent students. The study also obtained subjective reports of HIV/AIDS-relevant change. Overall there was a decrease in sexual risk-taking behaviour with casual partners but no change occurred in sexual behaviour with regular partners, knowledge about HIV/AIDS, attitude towards condoms, or intention to use a condom on next sexual encounter. Examination of individual data revealed that, for some adolescents where behavioural change had occurred, this was in the direction of less safe sex. There were few self-reports of change in sexual behaviour, intention to take precautions against HIV/AIDS, or concern about HIV/AIDS over the preceding 6 months. Subjective reports of behaviour change did not correspond with reports of actual behaviour. Low rates of behaviour change are attributed to the failure of adolescents to personalize the threat of AIDS and to their trust in the safety of sex with a regular partner as well as to the lack of relevance of HIV/AIDS education campaigns to this group.     

The prediction of condom use intention among South African university students

A questionnaire was administered to 294 sexually active, unmarried undergraduate students to investigate the role of social norms in the prediction of the intention to use condoms. Components of social cognitive theory and the theory of reasoned action and planned behaviour were integrated with those of the Health Belief Model to predict future intention to use condoms with a new partner. Logistic regression analyses of selected risky sexual behaviours on the intention to use condoms showed that, among males, attitudes towards using condoms and the Health Belief Model component of perceived barriers predicted the intention to use condoms. The Health Belief Model component of perceived benefits could not be interpreted. Attitudes, subjective norms and perceived self-efficacy were associated with female students' intention to use condoms. Implications for strategies of HIV/AIDS prevention are discussed.     

Determinants of intentions to practise safe sex among 16–25 year-olds

This study aimed at predicting intentions to avoid casual sex and to use condoms, through self-efficacy, attitudes, optimistic bias in perceived risk, knowledge and past sexual risk behaviour. To this end, a mixed-sex sample of high school and university students between 16 and 25 years completed questionnaires at two points in time. Intentions to avoid casual sex were predicted positively by the attitude towards avoiding casual sex and assertiveness in sexual relationships, and negatively by communication about sex. The intention to use condoms was predicted positively by the perceived benefits of condom use, and negatively by past sexual risk behaviour and fatalism. Gender and sexual experience were found to have a moderating influence, implying that AIDS education should use different messages for these target groups. Since the results show that condom use is quite a powerful habit and that sexually non-active subjects had more positive intentions towards safe sex, AIDS education should start at a young age in order to establish safe sex habits from the beginning. © 1997 John Wiley & Sons, Ltd.     

Identifying Precursors of Safer‐Sex Practices in Mexican Adolescents With and Without Sexual Experience: An Exploratory Model1

Theoretical variables were examined for their empirical relevance as precursors of safer‐sex behavior in 2,011 Mexican adolescents, most of whom were not sexually experienced. Using structural equation modeling, a good fit was found for a path model with (a) partner communication and intention to use condoms as outcome variables; (b) self‐esteem, self‐efficacy, and decision making as antecedent variables; and (c) perceived norms about sexual practices, attitudes toward condom use, and knowledge of HIV as mediating variables. A good fit also was found for a slightly elaborated model involving condom use as outcome variable that was fitted in a subsample with 319 adolescents who reported sexual experience. Gender differences are discussed, as well as implications for intervention programs promoting safer‐sex behaviors.     

Psychosocial correlates of condom use and their relationship with worry about STI and HIV in native and immigrant adolescents in Spain

The goal of this study was to analyze how worry about sexually-transmitted infections (STI) and HIV influences attitudes and self-efficacy towards condom use, HIV-related knowledge, HIV-perceived susceptibility and HIV-misconceptions in a multicultural sample in Spain. The sample was composed of 3,051 adolescents aged between 14 and 19 years old who lived in Spain. Of these, 67.7% were native Spaniards and the remaining 32.3% were Latin American immigrants. Results showed that worry about STI and HIV has a direct influence on condom use self-efficacy and HIV-knowledge and HIV-perceived susceptibility. Native Spanish adolescents showed higher positive attitudes towards condom use, greater HIV-knowledge and HIV-perceived susceptibility, and lower negative attitudes towards condoms use and HIV-misconceptions than Latin American adolescents. In the discussion, the importance of worry about STI and HIV is highlighted as a mediator variable that can predict risky sexual behavior and is related to cultural origin.     

The impact of depressive symptomatology on risky sexual behavior and sexual communication among African American female adolescents

Adolescents, particularly African American adolescents, are at high risk for sexually transmitted infections (STIs). The association between psychosocial factors and risky sexual behavior has been well established. However, only a small number of studies have examined the relationship between depressive symptomatology among African American female adolescents, specifically over time. The present study examined depressive symptoms as a predictor of risky sexual behavior, sexual communication, and STIs longitudinally among African American female adolescents between the ages 15 and 21. Binary generalized estimating equation models were conducted assessing the impact of depressive symptoms at baseline on risky sexual behavior and STIs over six- and 12-months follow-up. Age, intervention group, and baseline outcome measures were entered as covariates. The results indicated that high levels of depressive symptoms predicted no condom use during last sexual encounter and multiple sexual partners over six-months follow-up. Depressive symptoms also predicted having a main partner with concurrent partners, high fear of communication about condoms, and sex while high on alcohol or drugs over six- and 12-months follow-up. These findings could be used to inform HIV/STI prevention intervention programs and clinicians providing regular health care maintenance to African American female adolescents engaging in risky sexual behavior.     

Beliefs about condoms and accessibility of condom intentions in Hispanic and African American youth

The construct accessibility model (CAM) holds that constructs are most likely to influence behavior when they are accessible in memory. While the theory of reasoned action sees intention as an important determinant of behavior, the CAM predicts that the intention to act upon a given health behavior is not likely to be acted upon unless the intention is in an accessible state. Therefore, people who frequently talk about or think about using condoms are likely to have condom related constructs available and use them when needed. This paper reports findings from the pilot phase of a project to identify beliefs which influence condom use in Hispanic and African-American youth living in Detroit. 15 male and 15 female Hispanics and 17 male and 17 female African-Americans aged 15-21 years of mean and median age 18.5, were interviewed face-to-face in 1989 with the goal of identifying condom beliefs which may influence their condom use. 80-82% of male participants, 53% of Hispanic females, and 100% of Black females had experienced sexual intercourse, with age at first intercourse ranging between 13.1 and 16.5 years. 88% of Black women and 7% of Hispanic women were pregnant at the interview. Regarding participants' level of preventive knowledge, all but 1 recently immigrated Hispanic female knew HIV was transmitted by needles and sexual intercourse. 87% of Hispanics and 94% of African-Americans responded that condoms protect against AIDS, but only 13% of Hispanics and 47% of African-Americans knew that nonlatex condoms do not. Some participants expressed concern that condoms reduce sensitivity and/or break during intercourse. Controlling for sexual activity, 25% of Hispanic females, 83% of Hispanic males, 71% of African-American females, and 80% of African-American males had ever used a condom; no Hispanic and 14% of Blacks reported using them consistently in the 12 month period preceding the interview. With 100% of African-American males and 97% of Black females reporting thinking about using condoms compared to 80% of Hispanics, the study findings suggest that condom intentions are more accessible in African-Americans than among Hispanics.     

Factors Influencing Condom Use Among African American Women: Implications for Risk Reduction Interventions

Examined factors associated with condom use in a community-based sample of 423 sexually active African American women. Measures were selected to reflect the components in prevailing models of health behavior. Condom users were higher on AIDS health priority, prevention attitudes, stage of change, behavioral intentions, reported more frequent and comfortable sexual communication with partners, perceived greater partner and peer approval for condom use, and reported that peers also used condoms. Women in exclusive relationships evidenced earlier stage of change, lower intentions to use condoms, fewer peers who engaged in preventive behaviors, perceived themselves to have lower risk, and had lower rates of condom use, higher education, and family income. Women in fluid relationships were at particularly high risk, with lower rates of condom use relative to women not in a relationship and greater sexual risk for HIV. Implications for HIV-risk reduction interventions with African American women are discussed.     

Preliminary efficacy of a computer-based HIV intervention for African-American women

This study evaluated the preliminary efficacy of a computer-based HIV intervention to enhance HIV-protective sexual behaviours, based on a randomised controlled trial among 135 African-American women, 21-29 years of age, seeking services at Planned Parenthood in Atlanta, GA. Participants were randomised either to a control session two, 60-minute computer-based HIV intervention sessions administered on a laptop computer that each concluded with a 15-minute small group session or to a control session of general health information including discussion on HIV prevention. Relative to controls, participants in the computer-based HIV intervention were more knowledgeable about HIV/STD prevention and reported higher scores on the measure of condom use self-efficacy at 3 months post-intervention; they also reported a higher percentage of condom-protected sex and were more likely to use condoms consistently for vaginal sex (odds ratio, OR = 5.9; p < 0.039) and were more likely to use condoms consistently for oral sex (OR = 13.83; p < 0.037). This relatively brief intervention provides preliminary support that an evidence-based group-based HIV prevention intervention for young African-American women can be adapted to a computer-based HIV intervention.     

College Women and Condom Use: Importance of Partner Relationship

Because women who want to use condoms as protection against STDs must gain compliance from their male partners, women's use of condoms was examined within the context of their relationships with their sexual partners. Sexual history, condom attitudes, and relationship information were gathered from a sample of 272 heterosexual college women. For the 121 women with a current sexual partner, logistic regression analyses revealed that both regular condom use and completely consistent condom use were more likely in shorter relationships and for women who perceived lower barriers to use. Regular condom use was also greater in relationships described as high in trust, whereas consistent condom use was greater for women in their first sexual relationships. In addition, many women reported using condoms early in their relationships, but changing to lower levels of use later. Implications of the current findings for safer-sex interventions are discussed.     

Sexually Explicit Media and Sexual Risk Behavior in a Sample of Men Who Have Sex with Men in Norway

The aim of this study was to explore the association between the consumption of sexually explicit media (SEM) depicting condom and non-condom use and HIV/STI-related sexual risk behavior among men who have sex with men (MSM) in Norway. We also explored whether the association between SEM consumption and STI-related sexual risk behavior is mediated by men’s sexual self-esteem and/or condom use self-efficacy. A cross-sectional online survey study was carried out in Norway in 2012. The final sample comprised 529 MSM in Norway. There was a bivariate association between the use of SEM picturing condom use and less STI-related sexual risk behavior. Further, the association between SEM consumption and sexual risk behavior was mediated by condom use self-efficacy. However, SEM did not influence sexual risk behavior via sexual self-esteem. The results offer important cross-cultural validation of recent comparative data from the US and may be used to promote HIV/STI prevention, in the sense that the actors in SEM may serve as role models in managing condom use in sexual contexts.     

Factors affecting behaviors that address HIV risk among senior secondary school pupils in South Africa.

The purpose of this study was to identify factors affecting HIV risk reduction among senior secondary school pupils in South Africa. The sample included 460 Grade 12, Secondary School pupils whose ages ranged from 16 to 30 years (M = 19.7 yr., SD = 2.5) and who were chosen at random from the total Grade 12 population throughout one region in the Northern Province of South Africa. Measures were of sexual behavior and condom use, knowledge about correct condom use, intention of condom use, behavioral norms, attitudes, normative beliefs, and subjective norms about condoms, HIV/AIDS vulnerability (likelihood to get it) and severity of the illness in the country, and condom use self-efficacy. Bivariate analysis gave positive significant relations among normative beliefs, subjective norms, and attitudes towards condom use as well as HIV/AIDS vulnerability and HIV risk behavior. Regression analysis indicated that for boys, younger age at first vaginal intercourse, less intention for condom use, and HIV/AIDS vulnerability were predictive for HIV/AIDS risk behavior and explained 39% of the variance. It is suggested that these predictors should be included in intervention programs for HIV prevention.     

Condom use in steady and casual sexual relationships: Planning, preparation and willingness to take risks among adolescents

Condom use within steady and casual sexual relationships was examined among 14-16 year old Dutch adolescents from secondary school (N?=?140). It was hypothesised that among adolescents sex and subsequently condom use with casual sex partners is less likely to be considered in advance, more context-dependent and less habitual; whereas the opposite is true for steady relationships. Therefore, preparatory behaviours (buying and carrying condoms and communicating about condom use) were expected to mediate the intention-behaviour relation in the context of steady relationships, but not in the context of casual sex. Results confirmed that condom use with steady sex partners was explained by preparatory behaviours, habits, and to some extent, behavioural willingness, and that preparatory behaviours mediated the intention-behaviour relationship. Condom use with casual sex partners was predicted by risk willingness and intentions, without any mediation by preparatory behaviours. The results indicate that it is essential to increase awareness among adolescents that unexpected sexual situations may occur and to train them to take preparatory actions.     

A Comparison of Health Behavior Constructs: Social Psychological Predictors of AIDS-Preventive Behavioral Intentions

The present study focused on predicting AIDS-preventive behavioral intentions (i. e., intentions to discuss AIDS-related information and to use condoms) from constructs taken from the health belief model, the theory of reasoned action/planned behavior, and social cognitive theory. Questionnaire data were collected from 124 undergraduates using scales from previously published work as well as some new measures designed for this study. Perceived behavioral control, perceived risk, attitudes, self-efficacy, subjective norms, negative expected outcomes, and perceived severity of HIV infection were correlated with at least one intention measure; but regression analyses showed that perceived behavioral control was the strongest independent predictor of condom use intentions and of intentions to discuss AIDS information with a partner. Implications for theory and application are discussed.     

Social support,self-esteem and depression: Relationship with risk for sexually transmitted infections/HIV transmission

Sexually transmitted infections (STIs) and HIV are important health problems that affect adolescents. The aim of the present study was to analyze the relationship between 1) depression, self-esteem and perceived social support and 2) sexual risk behaviors according to gender. The sample used in this ex post facto study was composed of 1,005 adolescents of both sexes aged between 14 and 18 years. Participants completed several questionnaires in the classrooms of their secondary education schools. The questionnaires assessed depression, self-esteem and perceived social support and recorded information on sexual behavior and socio-demographic issues. Results showed that, among males, self-esteem predicted higher vaginal risk, depression was related to higher vaginal, anal and oral sexual risk, and perceived support from the family predicted lower vaginal and anal sexual risk. Among females, self-esteem was found to be associated with lower anal sexual risk and perceived support from friends predicted lower anal and oral sexual risk. The study highlights the importance of considering family and friends as well as gender differences in the prevention of STIs/HIV.     

Application of the Theory of Planned Behavior to Adolescents’ Condom Use: A Panel Study1

The authors report a longitudinal study of factors determining use of condoms with new sexual partners in a representative sample of 650 German youth. Measures derived from the theory of planned behavior (Ajzen, 1985) were obtained in 2 waves separated by 1 year. Consistent with the theory, intentions to use condoms could be predicted from attitudes, subjective norms, and perceived behavioral control with respect to this behavior; and actual condom use was strongly related to intentions and perceptions of control assessed in Wave 2. Due to changes in beliefs and attitudes over time, only about 10% of the variance in reported condom use was accounted for by intentions and perceived control assessed 1 year earlier. Reported condom use was found to exert a direct effect on later intentions, unmediated by their hypothesized antecedents. Theoretical and practical implications of these findings are discussed.     

Condom use among US students: the importance of confidence in normative and attitudinal perceptions

The author performed a study among U.S. undergraduates to test an earlier conclusion (D. Trafimow, 1994) that confidence in the correctness of one's perceptions of normative pressure to use a condom influences the correspondence between those perceptions and the intentions actually to perform the behavior. Consistent with previous findings (Trafimow), the participants' perceptions of normative pressure strongly predicted their intentions to use condoms only under conditions of extreme normative confidence. Otherwise, their attitudes were better predictors of their intentions to use condoms. In addition, 2 other variables (attitudinal confidence and perceived behavioral control) were found to be unimportant predictors of intentions. Results of a 2nd study suggest that behaviors performed by sexual partners and knowing the sexual partners affected the participants' normative confidence.     

Condom Negotiation in Heterosexually Active Men and Women: Development and Validation of a Condom Influence Strategy Questionnaire

The ability to negotiate condom use with a partner is a skill that sexually active men and women must have in order to avoid sexually transmitted diseases including HIV. Despite this fact, there is no psychometrically valid instrument in the literature to measure condom influence strategies. This investigation reports on the development and initial validation of the condom influence strategy questionnaire (CISQ). Exploratory and confirmatory analyses revealed and confirmed six influence strategies used by heterosexually active men and women to negotiate condom use. These CISQ subscales accounted for variance in safer sexual variables including sexual assertiveness, self-efficacy, and partner communication. Further, those who endorsed CISQ subscales were more likely to have intentions to use condoms consistently and to use condoms. Gender differences in subscales favoring women as the ones most likely to use influence strategies also emerged. Implications of these results as well as future directions for research are discussed.