Correlates of condom use and condom‐use motivation among young South Africans

A survey of South African secondary school students aged 12–17 years (n = 893) included measures designed to investigate relationships between beliefs about HIV/AIDS, condom use, interpersonal relationships, and two dependent measures: motivation to use condoms and reported condom use. We predicted that motivation would be an important correlate of reported condom use and that traditional cultural beliefs included in social cognition models would predict condom use motivation. Hierarchical multiple regression showed that 10% of the variance in reported condom use was accounted for by condom use motivation and age. Condom self‐efficacy, beliefs about condoms and injunctive norms accounted for much of the variance. Other beliefs included susceptibility to HIV and attribution of HIV to asexual sources such as witchcraft indicating that an expanded model of modifiable cognitions may be optimal when designing HIV interventions among young South Africans.     

Today I'll use a condom, but who knows about tomorrow: a daily process study of variability in predictors of condom use

OBJECTIVE: Most models of health behavior change applied to condom use behavior have focused on individual differences in theoretical constructs to explain condom use or nonuse, while ignoring the possibility that day-to-day within-person changes in these constructs may contribute to understanding behavior. The goal of the present study was to investigate day-to-day variability in condom use attitudes, self-efficacy, and behavioral intentions and assess the utility of this variability in predicting the likelihood of condom use each day. DESIGN: A 30-day Web-based structured daily diary was used to collect daily reports of sexual behaviors and data on theoretical predictors of condom use behavior from sexually active college students (N = 116). MAIN OUTCOME MEASURES: The authors investigated whether condom use attitudes, self-efficacy, and behavioral intentions vary day to day; whether this within-person variability predicts condom use behavior; and whether negative affective states explain this variability. RESULTS AND CONCLUSIONS: Within-person variability was found for each of the constructs. Within-person day-to-day changes in behavioral intentions and attitudes predicted the instances in which an individual used a condom and daily negative affect partially explained within-person day-to-day changes in behavioral intentions and self-efficacy. Implications for models of health behavior change and for behavior change interventions are discussed.     

HIV-protection through condom use: Testing the theory of planned behaviour in a community sample of heterosexual men in a high-income country

Given the increasing importance of heterosexual HIV-transmission in Europe and Switzerland, the present study tested the theory of planned behaviour (TPB) in a prospective study on the HIV-protection behaviour in a community sample of heterosexual men. The study focused on condom use in sexual encounters with new partners. Participants were 982 Swiss men between the ages of 25 and 65 who were surveyed using standardised questionnaires in two computer-assisted telephone interviews that took place in autumn 2002 and spring 2003. The TPB was able to predict condom use in sexual encounters with new and casual partners. In accordance with the theory, condom use was predicted by intention. Perceived behavioural control and attitude were significant predictors of intention, whereas subjective norm was not. Thus, in line with other studies, the present study highlighted the somewhat limited explanatory power of the theory. Further theoretical and empirical work is needed to develop extensions to the theory.     

Remembering the message: the use of a reminder cue to increase condom use following a safer sex intervention.

Condom use interventions may be more powerful if they provide cues to recall safe-sex messages when sexual activity occurs. The authors tested this notion by assigning sexually active introductory psychology students (N = 196) to a standard safe-sex intervention, a safe-sex with reminder intervention, or a control (drinking and driving) intervention. Participants assigned to the reminder intervention were given a "friendship bracelet" to wear and were instructed to have the bracelet remind them of the intervention. In a follow-up session (5-7 weeks later), they were asked questions pertaining to condom use. Of the 125 participants who had engaged in sexual intercourse, condom use at last intercourse was higher in the bracelet condition (55%) than in the standard (27%) or control (36%) conditions. The authors also found that the bracelet remained effective, even when participants were under the influence of alcohol. These findings therefore imply that health intervention programs may be more efficacious if they include strategies such as reminder cues to increase the salience of health information in the appropriate contexts.     

The fallacy of intimacy: sexual risk behaviour and beliefs about trust and condom use among men who have sex with men in South Africa

The objective of this study is to assess (1) whether beliefs about trust and condom use affect sexual risk behaviour, and (2) if beliefs about trust and condom use impact sexual risk behaviour directly or if this relationship is mediated by other determinants. The Information-Motivation-Behavioural Skills model was used as a framework for the mediation analysis. A diverse cohort of three hundred 18-40 year old men who have sex with men (MSM) residing in Pretoria, South Africa, were recruited and surveyed for this project. Findings indicate that men who report a high frequency of past unprotected anal intercourse are more likely to believe that it is not necessary to use condoms with a trusted or steady partner regardless of their current partnership status. This fallacy of intimacy appears to affect sexual risk behaviour through intentions and attitudes regarding safer sex practices. Based on these findings, we recommend that more attention be given in gaining a better understanding of how beliefs about trust and condom use are formed and how they can be changed among MSM in South Africa.     

Self-conscious emotions and self-regulation in the promotion of condom use

Two prospective studies examined the self-regulatory role of anticipated negative self-conscious emotions (ANSCE) in the theory of planned behavior. In Study 1, 147 undergraduates reported condom attitudes, perceived norms, self-efficacy, ANSCE (shame and guilt) should they not use condoms, and intentions to use condoms during the coming 6 weeks. At a 6-week follow-up, ANSCE predicted condom use intentions and behavior and partially mediated the effect of attitudes and norms on both. Study 2 experimentally tested the social nature of self-consciousness in ANSCE; 61 female undergraduates read a scenario priming the private-self or social-self or were assigned to a no-scenario control. They reported condom attitudes, perceived control, ANSCE, condom use intentions, and a 6-week follow-up. ANSCE again predicted condom use intentions. A test of moderated mediation indicated that ANSCE influenced condom intentions more in the social-self condition than in the control condition. Implications of these findings are discussed.     

Demographic correlates of constant condom use among sex workers in Tangail, Dhaka, Bangladesh

Consistent condom use, particularly by promiscuous individuals, is a major safeguard against sexually transmitted diseases, including HIV/AIDS. This study examines some demographic factors that may affect such use among Bangladeshi female commercial sex workers at a brothel in Tangail (n = 196; mean age = 23.44 years), and the streets of Dhaka (n = 112; mean age = 25.92 years). The chi2 results indicated that sex workers over 19 years of age were 2.52 times more likely than adolescents under 19 to work on the street rather than at a brothel (chi2 = 8.73, p < .0.01, OR = 2.52, 95% CI = 1.35-4.72). Brothel sex workers aged over 19 years reported 3.26 probability to regularly use condom with clients than those adolescents aged below 19 years (chi2 = 6.23, p < 0.01, OR = 3.26, 95% CI = 1.25-8.53). This study found age to be a significant demographic correlate of regular condom use, particularly, among the brothel workers.     

Effective communication of risks to young adults: using message framing and visual aids to increase condom use and STD screening

Sexually Transmitted Diseases (STDs)-including HIV/AIDS-are among the most common infectious diseases in young adults. How can we effectively promote prevention and detection of STDs in this high risk population? In a two-phase longitudinal experiment we examined the effects of a brief risk awareness intervention (i.e., a sexual health information brochure) in a large sample of sexually active young adults (n = 744). We assessed the influence of gain- and loss-framed messages, and visual aids, on affective reactions, risk perceptions, attitudes, behavioral intentions, and reported behaviors relating to the prevention and detection of STDs. Results indicate that gain-framed messages induced greater adherence for prevention behaviors (e.g., condom use), whereas loss-framed messages were more effective in promoting illness-detecting behaviors (e.g., making an appointment with a doctor to discuss about STD screening). The influence of the framed messages on prevention and detection of STDs was mediated by changes in participants' attitudes toward the health behaviors along with changes in their behavioral intentions. Moreover, when visual aids were added to the health information, both the gain- and loss-framed messages became equally and highly effective in promoting health behaviors. These results converge with other data indicating that well-constructed visual aids are often among the most highly effective, transparent, fast, memorable, and ethically desirable means of risk communication. Theoretical, economic, and public policy implications of these results are discussed.     

Theories of reasoned action and planned behavior as models of condom use: a meta-analysis

To examine how well the theories of reasoned action and planned behavior predict condom use, the authors synthesized 96 data sets (N = 22,594) containing associations between the models' key variables. Consistent with the theory of reasoned action's predictions, (a) condom use was related to intentions (weighted mean r. = .45), (b) intentions were based on attitudes (r. = .58) and subjective norms (r. = .39), and (c) attitudes were associated with behavioral beliefs (r. = .56) and norms were associated with normative beliefs (r. = .46). Consistent with the theory of planned behavior's predictions, perceived behavioral control was related to condom use intentions (r. = .45) and condom use (r. = .25), but in contrast to the theory, it did not contribute significantly to condom use. The strength of these associations, however, was influenced by the consideration of past behavior. Implications of these results for HIV prevention efforts are discussed.     

Questions of condom use in the Muslim and Catholic response to HIV and AIDS in Nairobi,Kenya

Religious leaders in Roman Catholic and Sunni Muslim communities in Kenya’s capital city of Nairobi are charged with responding in an official capacity to the pressing concerns facing their respective communities both theologically and practically. However, speaking about sexuality from a religious perspective particularly on the use of condoms in AIDS prevention has been rather troublesome topic many leaders and clergy find problematic discussing openly. This paper offers a comparative analysis of Muslim and Catholic views on sexuality by establishing the parameters within which to consider the presence and activity of Catholic and Muslim leaders in Kenya and the holistic, grassroots approach in responding to the AIDS epidemic in Nairobi regarding condom use.     

Alcohol, sexual arousal, and intentions to use condoms in young men: applying alcohol myopia theory to risky sexual behavior.

Data from 7 studies were aggregated to examine how reported sexual arousal and alcohol intoxication interact to affect attitudes and intentions toward engaging in unprotected sexual intercourse in college-age men (N = 358). When participants were in a sober or placebo condition, their self-reports of sexual arousal had no effect on their responses. When participants were intoxicated, however, those who felt sexually aroused reported more favorable attitudes, thoughts, and intentions toward having unprotected sex than did those who did not feel aroused. These findings support alcohol myopia theory (C. M. Steele & R. A. Josephs, 1990), which states that alcohol intoxication restricts attentional capacity so that people are highly influenced by the most salient cues in their environment. It is suggested that sexual arousal is a powerful internal cue that interacts with alcohol intoxication to enhance attitudes and intentions toward risky sexual behaviors.     

Personality as a determinant of beer and cider consumption among young men

Predictions, based on Eysenck's theory of personality, of relationships between personality and total beer and cider consumption in on-licences (pubs, clubs etc.) were tested with two samples of 18- to 21-yr-old males, one consisting of craftsmen employed in a variety of skilled manual occupations, and the other of students studying full-time on a variety of mainly degree and technician courses. In both samples, consumption was positively related to the E and P dimensions, but not to the N dimension, of the Eysenck Personality Questionnaire. It is suggested that the effects of N on consumption may be complex with high N scores being more attracted to alcohol by the relaxation and freedom from inhibition it provides, but also, because of their greater social anxieties, being less attracted to drinking in on-licences. Consumption was also positively related to the Eysenck Impulsiveness factor in both samples, and to the Eysenck Venturesomeness factor among the students, but not to Venturesomeness among the craftsmen. Personality groups formed from combinations of the personality scales showed large differences in mean consumption.     

Predicting rape events: The influence of intimate partner violence history,condom use resistance,and heavy drinking

Sexual aggression perpetration is a public health epidemic, and burgeoning research aims to delineate risk factors for individuals who perpetrate completed rape. The current study investigated physical and psychological intimate partner violence (IPV) history, coercive condom use resistance (CUR), and heavy episodic drinking (HED) as prospective risk factors for rape perpetration. Young adult men (N = 430) ages 21–30 completed background measures as well as follow‐up assessments regarding rape events perpetrated over the course of 3 months. Negative binomial regression with log link function was utilized to examine whether these risk factors interacted to prospectively predict completed rape. There was a significant interaction between physical IPV and HED predicting completed rape; men with high HED and greater physical IPV histories perpetrated more completed rapes during follow‐up than men with low HED at the same level of physical IPV. Moreover, psychological IPV and coercive CUR interacted to predict completed rape such that men with high coercive CUR and greater psychological IPV histories perpetrated more completed rapes throughout the follow‐up period than men with low coercive CUR at the same level of psychological IPV. Findings suggest targets for intervention efforts and highlight the need to understand the topography of different forms of aggression perpetration.     

Habit as both a direct cause of intention to use a condom and as a moderator of the attitude-intention and subjective norm-intention relations

Abstract

Undergraduates at an American university were asked questions about their attitudes, subjective norms, habits, and intentions towards using a condom during sexual intercourse. Consistent with previous research (Chan and Fishbein, 1993; Trafimow, 1994), intentions were well predicted by attitudes and subjective norms (r = 0.88 and r = 0.73, p < 0.01 in both cases). Intentions were also well predicted by habits (r = 0.77, p < 0.01). More interestingly, however, for participants who were in the habit of using condoms, attitudes and subjective norms were not significant predictors of intentions to use condoms in the future (r = 0.18 and r = 0.10, p<0.1 in both cases). In contrast, attitudes and subjective norms were strong predictors for participants who were not in the habit of using condoms (r = 0.81 and r = 0.61, p < 0.01 in both cases). These findings were replicated in a second study.