Top

Published in:

01-01-2014 | Original Paper

Predicting Condom Use in South Africa: A Test of Two Integrative Models

Authors: Sander M. Eggers, Leif E. Aarø, Arjan E. R. Bos, Catherine Mathews, Hein de Vries

Published in: AIDS and Behavior | Issue 1/2014

Abstract

This study tested two integrative socio-cognitive models, namely the information–motivation–behavioral skills model (IMB) and the I-Change model (ICM), to assess their hypothesized motivational pathways for the prediction of condom use during last sexual intercourse. Students (N = 1066) from Cape Town, South Africa, filled out questionnaires at three different time points. Structural equation modeling demonstrated that self-efficacy did not predict behavior directly but indirectly via intention. Knowledge of how to use a condom and how STIs are transmitted directly predicted behavior when modeled as hypothesized by the IMB model, but indirectly when the factors attitude, subjective norms and self-efficacy were included as mediators, as hypothesized by the ICM. It is concluded that the ICM and IMB are similar in terms of model fit and explained variance, but that the ICM had a higher proportion of significant pathways.

UNAIDS. Global Report: UNAIDS report on the global AIDS epidemic: Joint United Nations Programme on HIV/AIDS; 2010.

Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Pillay-van-Wyk V, et al. South African national HIV prevalence, incidence, behaviour and communication survey 2008: a turning tide among teenagers?. Cape Town: HSRC; 2009.

Reddy P, James S, Sewpaul S, Koopman F, Funani N, Sifunda S, et al. Umthente uhlaba usamila: the 2nd South African youth risk behaviour survey 2008. Cape Town: South African Medical Research Council; 2010.

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

Eaton L, Flisher AJ, Aarø LE. Unsafe sexual behaviour in South African youth. Soc Sci Med. 2003;56(1):149–65.PubMedCrossRef

Hendriksen ES, Pettifor A, Lee SJ, Coates TJ, Rees HV. Predictors of condom use among young adults in South Africa: the reproductive health and HIV research unit national HIV survey. Am J Public Health. 2007;97(7):1241–8.PubMedCrossRef

Jewkes R, Levin JB, Penn-Kekana LA. Gender inequalities, intimate partner violence and HIV preventive practices: findings of a South African cross-sectional study. Soc Sci Med. 2003;56:125–34.PubMedCrossRef

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. S. Afr. AIDS Care. 2006;18(3):178–82.CrossRef

Kaufman MR, Shefer T, Crawford M, Simbayi LC, Kalichman SC. Gender attitudes, sexual power, HIV risk: a model for understanding HIV risk behavior of South African men. AIDS Care. 2008;20(4):434–41.PubMedCrossRef

10.

MacPhail C, Campbell C. `I think condoms are good but, aai, i hate those things’: condom use among adolescents and young people in a Southern African township. Soc Sci Med. 2001;52(11):1613–27.PubMedCrossRef

11.

Pettifor A, Measham D, Rees HV, Padian NS. Sexual power and HIV risk, South Africa. Emerg. Infect. Dis. 2004. http://www.cdc.gov/ncidod/EID/vol10no11/04-0252.htm. Accessed on 25 Jul 2011.

12.

Albarracin D, Johnson BT, Fishbein M, Muellerleile PA. Theories of reasoned action and planned behavior as models of condom use: a meta-analysis. Psychol Bull. 2001;127:142–61.PubMedCrossRef

13.

Sheeran P, Abraham C, Orbell S. Psychosocial correlates of heterosexual condom use: a meta-analysis. Psychol Bull. 1999;125(1):90–132.PubMedCrossRef

14.

Janz NK, Becker MH. The health belief model: a decade later. Health Educ Behav. 1984;11(1):1–47.CrossRef

15.

Rosenstock IM. Why people use health services. Milbank Q. 1966;44(3):94–127.

16.

Maddux JE, Rogers RW. Protection Motivation Theory and self-efficacy: A revised theory of fear appeals and attitude change. J Exp Soc Psychol. 1983;19:469–79.CrossRef

17.

Prentice-Dunn S, Rogers RW. Protection motivation theory and preventive health: beyond the health belief model. Health Educ Res. 1986;1:153–61.CrossRef

18.

Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice-Hall; 1986.

19.

Ajzen I. The theory of planned behavior. Organ Behav Hum Dec. 1991;50:179–211.CrossRef

20.

Albarracin D, Gillette JC, Earl AN, Glasman LR, Durantini MR, Ho M. A test of major assumptions about behavior change: a comprehensive look at the effects of passive and active HIV-prevention interventions since the beginning of the epidemic. Psychol Bull. 2005;31(6):856–97.CrossRef

21.

Harrison A, Newell M-L, Imrie J, Hoddinott G. HIV Prevention for South-African youth: which interventions work? a systematic review of current evidence. BMC Public Health. 2010;10:102.PubMedCentralPubMedCrossRef

22.

Ingram BL, Flannery D, Elkavich A, Rotheram-Borus MJ. Common processes in evidence-based adolescent HIV prevention programs. AIDS Behav. 2008;12:374–83.PubMedCrossRef

23.

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

24.

Fisher WA, Fisher JD, Harman J. The information–motivation–behavioral skills model: a general social psychological approach to understanding and promoting health behavior. In: Suls J, Wallston KA, editors. Social psychological foundations of health and illness. Malden: Blackwell; 2003.

25.

De Vries H, Mesters I, van de Steeg H, Honing C. The general public’s information needs and perceptions regarding hereditary cancer: an application of the integrated change model. Patient Educ Couns. 2005;56:154–65.PubMedCrossRef

26.

De Vries H, van Osch L, Eijmael K, Smerecnik C, Candel M. The role of risk perception in explaining parental sunscreen use. Psychol Health. 2012;27(11):1342–58.PubMedCrossRef

27.

Fisher JD, Fisher WA. Changing AIDS-Risk behavior. Psychol Bull. 1992;111(3):455–74.PubMedCrossRef

28.

Fisher WA, Williams SS, Fisher JD, Malloy TE. understanding AIDS risk behavior among sexually active urban adolescents: an empirical test of the information–motivation–behavioral skills model. AIDS Behav. 1999;3(1):13–23.CrossRef

29.

Robertson AA, Stein JA, Baird-Thomas C. gender differences in the prediction of condom use among incarcerated juvenile offenders: testing the information–motivation–behavioral skills (IMB) model. J Adolescent Health. 2006;38:18–25.CrossRef

30.

Ybarra M, Korchmaros J, Kiwanuka J, Bangsberg D, Bull S. Examining the Applicability of the IMB Model in Predicting Condom Use Among Sexually Active Secondary School Students in Mbarara, Uganda. AIDS Behav. 2012:1–13.

31.

Molla M, Astr NA, Brehane Y. Applicability of the theory of planned behavior to intended and self-reported condom use in a rural Ethiopian population. AIDS Care. 2007;19(3):425–31.PubMedCrossRef

32.

Muñoz-Silva A, Sánchez-García M, Nunes C, Martins A. Gender differences in condom use prediction with theory of reasoned action and planned behaviour: the role of self-efficacy and control. AIDS Care. 2007;19(9):1177–81.PubMedCrossRef

33.

Mustanski B, Donenberg G, Emerson E. I can use a condom, i just don’t: the importance of motivation to prevent HIV in adolescent seeking psychiatric care. AIDS Behav. 2006;10:753–62.PubMedCrossRef

34.

Anderson ES, Wagstaff DA, Heckman TG, Winett RA, Roffman RA, Solomon LJ, et al. Information–motivation–behavioral skill (IMB) model: treatment effects on condom use among women in low-income housing. Ann Behav Med. 2006;31(1):70–9.PubMedCrossRef

35.

Kalichman SC, Malow R, Devieux J, Stein JA, Piedman F. HIV risk reduction for substance using seriously mentally ill adults: tests of the information–motivation–behavioral skills (IMB) model. Community Ment Health J. 2005;41(3):277–90.PubMedCentralPubMedCrossRef

36.

Kalichman SC, Stein JA, Malow R, Averhart C, Devieux J, Jennings T, et al. Predicting protected sexual behaviour using the information-motivation-behaviour skills model among adolescent substance abusers in court-ordered treatment. Psychol Health Med. 2002;7(3):327–38.PubMedCentralPubMedCrossRef

37.

De Vries H, Mudde A, Leijs I, Charlton A, Vartiainen E, Buijs G, et al. The european smoking prevention framework approach (EFSA): an example of integral prevention. Health Educ Res. 2003;18(5):611–26.PubMedCrossRef

38.

Dijk F, Reubsaet A, De Nooijer J, De Vries H. Smoking status and peer support as the main predictors of smoking cessation in adolescents from six European countries. Nicotine Tob Res. 2007;9:S495–504.PubMedCrossRef

39.

De Vries H, Kremers SPJ, Smeets T, Brug J, Eijmael K. The effectiveness of tailored feedback and action plans in an intervention addressing multiple health behaviors. Am J Health Promot. 2008;22(6):417–25.PubMedCrossRef

40.

Schneider F, van Osch L, Kremers SPJ, Schulz DN, van Adrichem M, De Vries H. Optimizing diffusion of an online computer tailored lifestyle program: a study protocol. BMC Public Health. 2011;11:480.PubMedCentralPubMedCrossRef

41.

De Vries H, Lezwijn J, Hol M, Honing C. Skin cancer prevention: behaviour and motives of Dutch adolescents. Eur J Cancer Prev. 2005;14:39–50.PubMedCrossRef

42.

Knops-Dullens T, De Vries N, De Vries H. Reasons for non-attendance in cervical cancer screening programmes: an application of the integrated model for behavioural change. Eur J Cancer Prev. 2007;16:436–45.PubMedCrossRef

43.

Nierkens V, Stronks K, Van Oel CJ, De Vries H. Beliefs of Turkish and Moroccan immigrants in the Netherlands about smoking cessation: implications for prevention. Health Educ Res. 2005;20(6):622–34.PubMedCrossRef

44.

Panday S, Reddy SP, Ruiter RAC, Bergstrom E, De Vries H. Determinants of smoking among adolescents in the Southern Cape-Karoo region. S Afr Health Promot Int. 2007;22(3):207–17.CrossRef

45.

Jewkes R, Nduna M, Levin J, Jama N, Dunkle K, Puren A, et al. Impact of stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. BMJ. 2008;337:a506.PubMedCentralPubMedCrossRef

46.

Kirby DB. The impact of abstinence and comprehensive sex and STI education programs on adolescent sexual behavior. Sex Res Soc Policy. 2008;5(3):18–27.CrossRef

47.

Noar SM, Zimmerman RS. Health behavior theory and cumulative knowledge regarding health behaviors: are we moving in the right direction? Health Educ Res. 2005;20(3):275–90.PubMedCrossRef

48.

Weinstein ND. Testing four competing theories of health-protective behavior. Health Psychol. 1993;12(4):324–33.PubMedCrossRef

49.

Mathews C, Aarø LE, Grimsrud A, Flisher AJ, Kaaya S, Onya H, et al. Effects of the SATZ teacher-led school HIV-prevention programmes on adolescent sexual behaviour: cluster randomised controlled trials in three sub-Saharan African sites. Int Health. 2012;4:111–22.PubMedCrossRef

50.

Seebregts CJ, Zwarenstein M, Mathews C, Fairall L, Flisher AJ, Seebregts C, et al. Handheld computers for survey data and trial data collection in resource-poor settings: development and evaluation of PDACT, a palm pilot interviewing system. Int J Med Inform. 2009;78:721–31.PubMedCrossRef

51.

Mukoma W, Flisher AJ, Helleve A, Aarø LE, Mathews C, Kaaya S, et al. Development and test-retest reliability of a research instrument designed to evaluate school-based HIV/AIDS interventions in South Africa and Tanzania. Scand J Public Health. 2009;37:7–15.PubMedCrossRef

52.

Aarø LE, Flisher AJ, Kaaya S, Onya H, Fuglesang M, Klepp K-I, et al. Promoting sexual and reproductive health in early adolescence in South Africa and Tanzania: development of a theory and evidence-based intervention programme. Scand J Public Health. 2006;34(2):150–8.PubMedCrossRef

53.

Muthén LK, Muthén BO. Mplus user’s guide: sixth edition. Los Angeles, CA: Muthén & Muthén; 2010.

54.

Taylor AB, MacKinnon DP, Tein J-Y. Tests of the three-path mediated effect. ORM. 2008;11:241–69.

55.

Cole DA, Maxwell SE. Testing mediational models with longitudinal data. J Abnorm Psychol. 2003;112:558–77.PubMedCrossRef

56.

MacKinnon DP. Introduction to statistical mediation analysis. New York: Erlbaum and Taylor Francis Group; 2008.

57.

Hu L, Bentler PM. Cut off criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model. 1999;6(1):1–55.CrossRef

58.

Flora DB, Curran PJ. An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychol Methods. 2004;9(4):466–91.PubMedCentralPubMedCrossRef

59.

Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51(6):1173–82.PubMedCrossRef

60.

Bryan A, Fisher JD, Fisher WA. Tests of the mediational role of preparatory safer sexual behavior in the context of the theory of planned behavior. Health Psychol. 2002;21(1):71–80.PubMedCrossRef

61.

Fishbein M. The role of theory in HIV prevention. AIDS Care. 2000;12(3):273–8.PubMedCrossRef

62.

Rhodes F, Stein JA, Fishbein M, Goldstein RB, Rotheram-Borus MJ. Using theory to understand how interventions work: project respect, condom use, and the integrative model. AIDS Behav. 2007;11:393–407.PubMedCrossRef

63.

Mittal M, Senn TE, Carey MP. Intimate partner violence and condom use among women: does the information–motivation–behavioral skills model explain sexual risk behavior? AIDS Behav. 2012;16(4):1011–9.PubMedCentralPubMedCrossRef

64.

Vermeer W, Bos AE, Mbwambo J, Kaaya S, Schaalma HP. Social and cognitive variables predicting voluntary HIV counceling and testing among Tanzanian medical students. Patient Educ Couns. 2009;75(1):135–40.PubMedCrossRef

65.

Sheeran P, Abraham C. Measurement of condom use in 72 studies of HIV-preventive behaviour: a critical review. Patient Educ Couns. 1994;24:199–216.PubMedCrossRef

Title: Predicting Condom Use in South Africa: A Test of Two Integrative Models
Authors: Sander M. Eggers
Leif E. Aarø
Arjan E. R. Bos
Catherine Mathews
Hein de Vries
Publication date: 01-01-2014
Publisher: Springer US
Published in: AIDS and Behavior / Issue 1/2014
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-013-0423-2

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Predicting Condom Use in South Africa: A Test of Two Integrative Models

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

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

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2014

Bringing Your Baggage to Bed: Associations of Previous Relationship Experiences with Sexual Risk

Associations Between Perceived Characteristics of the Peer Social Network Involving Significant Others and Risk of HIV Transmission Among Men Who Have Sex with Men in China

A Continuing HIV Epidemic and Differential Patterns of HIV-STI Risk among MSM in Quito, Ecuador: An Urgent Need to Scale Up HIV Testing and Prevention

Sexual Partnerships with Men and Women Among Men Who Have Sex with Men in Beijing and Chongqing, China, 2010

Self-Efficacy Among Young Men Who have Sex with Men: An Exploratory Analysis of HIV/AIDS Risk Behaviors Across Partner Types

HIV Among Black Men Who Have Sex with Men (MSM) in the United States: A Review of the Literature

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

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

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page