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

• Published in: AIDS and behavior Vol. 18; no. 1; pp. 135 - 145
• Main Authors: Eggers, Sander M., Aarø, Leif E., Bos, Arjan E. R., Mathews, Catherine, de Vries, Hein
• Format: Journal Article
• Language: English
• Published: Boston Springer US 2014; Springer Nature B.V
• Subjects: Adult; Attitudes; Behavioral decision theory; Cape Town, South Africa; Coitus - psychology; Condoms; Condoms - utilization; Empowerment; Female; Health Knowledge, Attitudes, Practice; Health Psychology; HIV; Human immunodeficiency virus; Humans; Infectious Diseases; Knowledge; Male; Medicine; Medicine & Public Health; Middle Aged; Models, Psychological; Motivation; Original Paper; Public Health; Risk Factors; Self Efficacy; Sexual behavior; Sexual Intercourse; Skills; Socioeconomic Factors; South Africa; Students; Students - psychology; Students - statistics & numerical data; Studies; Surveys and Questionnaires; Teenagers; South Africa; Condom use; Information–motivation–behavioral skills model; I-Change model; HIV; Theory of planned behavior
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-013-0423-2

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.