Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
AIDS and Behavior
Published in: AIDS and Behavior 3/2013

01-03-2013 | Original Paper

Examining the Applicability of the IMB Model in Predicting Condom Use Among Sexually Active Secondary School Students in Mbarara, Uganda

Authors: Michele L. Ybarra, Josephine Korchmaros, Julius Kiwanuka, David R. Bangsberg, Sheana Bull

Published in: AIDS and Behavior | Issue 3/2013

Login to get access

Abstract

The applicability of the IMB model in predicting condom use was tested among 390 sexually active secondary school students in Mbarara, Uganda. Adolescents across five secondary schools completed a self-report survey about their health and sexual experiences. Based upon results from structural equation modeling, the IMB model partially predicts condom use. Condom use was directly predicted by HIV prevention information and behavioral skills regarding having and using condoms. It was indirectly predicted (through behavioral skills regarding having and using condoms) by behavioral intentions regarding using condoms and talking to one’s partner about safer sex. Aspects of one’s first sexual experience (i.e., age at first sex, having discussed using condoms with first sex partner, willingness at first sex) were strongly influential in predicting current condom use; this was especially true for discussing condoms with one’s first sex partner. Findings highlight the importance of providing clear and comprehensive condom use training in HIV prevention programs aimed at Ugandan adolescents. They also underscore the importance of targeting abstinent youth before they become sexually active to positively affect their HIV preventive behavior at their first sexual experience.
Footnotes
1
In the first school the survey was fielded, students were not matched to the recruitment list in order to protect anonymity. This process was subsequently changed after it was discovered that youth not on the list had shown up, provided assent, and completed the survey. Because the surveys were completely blind to protect participants' anonymity; it was impossible to identify the errant surveys. Although we could have randomly deleted 17 surveys, we chose to keep all completed surveys to maximize the amount of data available.
 
Literature
1.
2.
Biraro S, Shafer LA, Kleinschmidt I, et al. Is sexual risk taking behaviour changing in rural south-west Uganda? Behaviour trends in a rural population cohort 1993–2006. Sex Transm Infect. 2009;85(Suppl 1):i3–11.PubMedCrossRef
3.
Johnson WD, Diaz RM, Flanders WD, et al. Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. Cochrane Database Syst Rev. 2008;3:CD001230.
4.
5.
Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice Hall; 1986.
6.
Azjen I, Fishbein M. Understanding attitudes and predicting social behavior. Englewood Cliffs: Prentice Hall; 1980.
7.
Azjen I. From intentions to actions: a theory of planned behavior. In: Kuhl J, Beckman J, editors. Action-control: from cognition to behavior. Heidelberg: Springer; 1985. p. 11–39.
8.
9.
Fisher JD, Fisher WA. Theoretical approaches to individual-level change in HIV risk behavior. In: Peterson JL, DiClemente RJ, editors. Handbook of HIV prevention. New York: Kluwer Academic/Plenum Press; 2000. p. 3–55.CrossRef
10.
Prochaska JO, Redding CA, Harlow LL, Rossi JS, Velicer WF. The transtheoretical model of change and HIV prevention: a review. Health Educ Q. 1994;21(4):471–86.PubMedCrossRef
11.
Rosenstock IM. Historical origins of the health belief model. Health Edu Monogr. 1974;2(4):328–35.
12.
Rogers EM. Diffusion of innovations. New York: Free Press; 1995.
13.
Wingood GM, DiClemente RJ. Application of the theory of gender and power to examine HIV-related exposures, risk factors, and effective interventions for women. Health Edu Behav. 2000;27(5):539–65.CrossRef
14.
Fisher JD, Fisher WA, Williams SS, Malloy TE. Empirical tests of an information-motivation-behavioral skills model of AIDS-preventive behavior with gay men and heterosexual university students. Health Psychol. 1994;13(3):238–50.PubMedCrossRef
15.
Fisher JD, Fisher WA, Bryan AD, Misovich SJ. Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth. Health Psychol. 2002;21(2):177–86.PubMedCrossRef
16.
Bryan AD, Fisher JD, Benziger TJ. HIV prevention information, motivation, behavioral skills and behaviour among truck drivers in Chennai, India. AIDS. 2000;14(6):756–8.PubMedCrossRef
17.
Linn JG, Garnelo L, Husaini BA, Brown C, Benzaken AS, Stringfield YN. HIV prevention for indigenous people of the Amazon basin. Cell Mol Biol (Noisy-le-grand). 2001;47(6):1009–15.
18.
Kalichman SC, Simbayi LC, Cain D, Jooste S, Skinner D, Cherry C. Generalizing a model of health behaviour change and AIDS stigma for use with sexually transmitted infection clinic patients in Cape Town, South Africa. AIDS Care. 2006;18(3):178–82.PubMedCrossRef
19.
Yang X, Xia G, Li X, Latkin C, Celentano D. Social influence and individual risk factors of HIV unsafe sex among female entertainment workers in China. AIDS Edu Prev. 2010;22(1):69–86.CrossRef
20.
Maticka-Tyndale E, Tenkorang EY. A multi-level model of condom use among male and female upper primary school students in Nyanza, Kenya. Soc Sci Med. 2010;71(3):616–25.PubMedCrossRef
21.
Hendriksen ES, Pettifor A, Lee SJ, Coates T, Rees H. Predictors of condom use among young adults in South Africa: The Reproductive Health and HIV Research Unit National Youth Survey. Am J Public Health. 2007;97(7):1241–8.PubMedCrossRef
22.
Koenig MA, Zablotska I, Lutalo T, Nalugoda F, Wagman J, Gray R. Coerced first intercourse and reproductive health among adolescent women in Rakai, Uganda. Int Fam Plan Perspect. 2004;30(4):156–63.PubMedCrossRef
23.
Kalichman SC, Simbayi LC. Sexual assault history and risks for sexually transmitted infections among women in an African township in Cape Town, South Africa. AIDS Care. 2004;16(6):681–9.PubMedCrossRef
24.
Varga C. How gender roles influence sexual and reproductive health among South African adolescents. Stud Fam Plann. 2003;34(3):160–72.PubMedCrossRef
25.
Moore A, Biddlecom A, Zulu E. Prevalence and meanings of exchange of money or gifts for sex in unmarried adolescent sexual relationships in sub-Saharan Africa. Afr J Reprod Health. 2007;11(3):44–61.PubMedCrossRef
26.
Ajuwon A. Attitudes, norms and experiences of sexual coercion among young people in Ibadan, Nigeria. In: Jejeebhoy S, Shah I, Thapa S, editors. Sex without consent: young people in developing countries. New York: Zed Books; 2005. p. 96–104.
27.
Erulkar A. The experience of sexual coercion among young people in Kenya. Int Fam Plan Perspect. 2004;30(4):182–9.PubMedCrossRef
28.
Dunkle KL, Jewkes RK, Brown HC, Gray GE, McIntryre JA, Harlow SD. Gender-based violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa. Lancet. 2004;363(9419):1415–21.PubMedCrossRef
29.
Luke N, Kurz KM. Cross-generational and transactional sexual relations in Sub-Saharan Africa: prevalence of behavior and implications for negotiating safer sexual practices. Washington, DC: International Center for Research on Women, Population Services International; 2002.
30.
Campbell JC, Baty ML, Ghandour RM, Stockman JK, Francisco L, Wagman J. The intersection of intimate partner violence against women and HIV/AIDS: a review. Int J Inj Contr Saf Promot. 2008;15(4):221–31.PubMedCrossRef
31.
Jewkes R, Morrell R. Gender and sexuality: emerging perspectives from the heterosexual epidemic in South Africa and implications for HIV risk and prevention. J Int AIDS Soc. 2010;13(1):6.PubMed
32.
Maman S, Yamanis T, Kouyoumdjian F, Watt M, Mbwambo J. Intimate partner violence and the association with HIV risk behaviors among young men in Dar es Salaam, Tanzania. J Interpers Violence. 2010;25(10):1855–72.PubMedCrossRef
33.
Puffer E, Meade C, Drabkin A, Broverman S, Ogwang-Odhiambo R, Sikkema K. Individual- and family-level psychosocial correlates of HIV risk behavior among youth in rural Kenya. AIDS Behav. 2010;15(6):1264–74.CrossRef
34.
Uganda Bureau of Statistics (UBOS). Statistical abstract. Kampala: Uganda Bureau of Statistics; 2005. p. 2005.
35.
36.
37.
38.
Bryan A, Schindeldecker MS, Aiken LS. Sexual self-control and male condom-use outcome beliefs: predicting heterosexual men’s condom-use intentions and behavior. J Appl Soc Psychol. 2001;31(9):1911–38.CrossRef
39.
Bryan AD, Aiken LS, West SG. Young women’s condom use: the influence of acceptance of sexuality, control over the sexual encounter, and perceived susceptibility to common STDs. Health Psychol. 1997;16(5):468–79.PubMedCrossRef
40.
Ware JE, Kosinski M. SF-36 physical and mental health summary scales: a manual for users of version 1. Lincoln: QualityMetric Inc.; 2001.
41.
Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988;52(1):30–41.CrossRef
42.
Rosenberg M. Society and the adolescent self-image. Princeton: Princeton University Press; 1965.
43.
Whitaker DJ, Miller KS, Clark LF. Reconceptualizing adolescent sexual behavior: beyond did they or didn’t they? Fam Plann Perspect. 2000;32(3):111–7.PubMedCrossRef
44.
Bryan A, Kagee A, Broaddus M. Condom use among South African adolescents: developing and testing theoretical models of intentions and behavior. AIDS Behav. 2006;10(4):387–97.PubMedCrossRef
45.
StataCorp. Stata Statistical Software. Release 11. College Station, TX: StataCorp LP; 2009.
46.
Rubin DB. Multiple imputation for nonresponse in surveys. New York: Wiley; 1987.CrossRef
47.
Ybarra ML, Mitchell KJ. Youth engaging in online harassment: associations with caregiver-child relationships, internet use, and personal characteristics. J Adolesc. 2004;27(3):319–36.PubMedCrossRef
48.
Ybarra M, Mitchell K, Wolak J, Finkelhor D. Examining characteristics and associated distress related to internet harassment: findings from the Second Youth Internet Safety Survey. Pediatrics. 2006;118(4):e1169–77.PubMedCrossRef
49.
Ybarra ML, Espelage DL, Mitchell KJ. The co-occurrence of internet harassment and unwanted sexual solicitation victimization and perpetration: associations with psychosocial indicators. J Adolesc Health. 2007;41(6 Suppl 1):S31–41.PubMedCrossRef
50.
Arbuckle JL. Amos user’s guide. Chicago: Small Waters; 1997.
51.
Sobel ME. Asymptotic confidence intervals for indirect effects in structural models. In: Leinhardt S, editor. Sociological methodology. San Francisco: Jossey-Bass; 1982. p. 290–312.
52.
Kline RB. Principles and practice of structural equation modeling. 3rd ed. New York: Guildford Press; 2011.
53.
Walsh J, Senn T, Scott-Sheldon L, Vanable P, Carey M. Predicting condom use using the Information-Motivation-Behavioral Skills (IMB) model: a multivariate latent growth curve analysis. Ann Behav Med. 2011;42(2):235–44.PubMedCrossRef
54.
Anderson ES, Wagstaff DA, Heckman TG, et al. Information-Motivation-Behavioral Skills (IMB) Model: testing direct and mediated treatment effects on condom use among women in low-income housing. Ann Behav Med. 2006;31(1):70–9.PubMedCrossRef
55.
Nideröst S, Gredig D, Roulin C, Rickenbach M. Cohort Study, Eurosupport 5 Study Group. Predictors of HIV-protection behaviour in HIV-positive men who have sex with casual male partners: a test of the explanatory power of an extended Information-Motivation-Behavioural Skills model. AIDS Care. 2011;23(7):908–19.PubMed
56.
Fisher JD, Fisher WA, Shuper PA. The Information-Motivation-Behavioral Skills model of HIV preventive behavior. In: DiClemente R, Crosby R, Kegler M, editors. Emerging theories in health promotion practice and research. San Francisco: Jossey Bass Publishers; 2009. p. 22–63.
57.
MacPhail C, Pettifor A, Pascoe S, Rees H. Predictors of dual method use for pregnancy and HIV prevention among adolescent South African women. Contraception. 2007;75(5):383–9.PubMedCrossRef
58.
Moore AM, Awusabo-Asare K, Madise N, John-Langba J, Kumi-Kyereme A. Coerced first sex among adolescent girls in sub-Saharan Africa: prevalence and context. Afr J Reprod Health. 2007;11(3):62–82.PubMedCrossRef
59.
Råssjö E-B, Kiwanuka R. Views on social and cultural influence on sexuality and sexual health in groups of Ugandan adolescents. Sex Reprod Healthc. 2010;1(4):157–62.PubMedCrossRef
60.
Wagman J, Baumgartner JN, Waszak Geary C, et al. Experiences of sexual coercion among adolescent women. J Interpers Violence. 2009;24(12):2073–95.PubMedCrossRef
61.
Nduna M, Jewkes R, Dunkle K, Shai N, Colman I. Associations between depressive symptoms, sexual behaviour and relationship characteristics: a prospective cohort study of young women and men in the Eastern Cape, South Africa. J Int AIDS Soc. 2010;13(1):44.PubMedCrossRef
62.
Miller C, Bangsberg D, Tuller D, et al. Food insecurity and sexual risk in an HIV endemic community in Uganda. AIDS Behav. 2011;15(7):1512–9.PubMedCrossRef
63.
Bandura A. Self-efficacy: the exercise of control. New York: W.H. Freeman; 1997.
64.
Fisher JD, Fisher WA, Misovich DL, Kimble JD, Malloy TE. Changing AIDS risk behavior: effects of an intervention emphasizing AIDS risk reduction information, motivation, and behavioral skills in a college student population. Health Psychol. 1996;15(2):114–23.PubMedCrossRef
Metadata
Title
Examining the Applicability of the IMB Model in Predicting Condom Use Among Sexually Active Secondary School Students in Mbarara, Uganda
Authors
Michele L. Ybarra
Josephine Korchmaros
Julius Kiwanuka
David R. Bangsberg
Sheana Bull
Publication date
01-03-2013
Publisher
Springer US
Published in
AIDS and Behavior / Issue 3/2013
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-012-0137-x

Other articles of this Issue 3/2013

AIDS and Behavior 3/2013 Go to the issue

Original Paper

Dual Process Interaction Model of HIV-Risk Behaviors Among Drug Offenders

Original Paper

Condom Use with Serious and Casual Heterosexual Partners: Findings from a Community Venue-Based Survey of Young Adults

Original Paper

Rates and Correlates of HIV and STI Infection Among Homeless Women

Original Paper

Occurrence of New Sexually Transmitted Diseases in Males After HIV Diagnosis

Original Paper

Prevalence and Predictors of Drug Use Among Adolescents with HIV Infection Acquired Perinatally or Later in Life

Original Paper

Predictors of Responsiveness Among Early Adolescents to a School-Based Risk Reduction Intervention Over 3 Years

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits