Abstract
We developed and tested models of intentions and behavior among adolescents from Cape Town, South Africa. Data from 261 participants who completed an initial measure of attitudes, beliefs, and prior behavior were used to develop a model of intentions to use condoms based on the Theory of Planned Behavior (TPB) and additional constructs found to be important in previous research with adolescents. Of the initial sample, 227 (87%) completed a behavioral follow-up 4 months later, and approximately one-third of those (n=72; 44 boys and 30 girls) reported having had sex in the prior 4 months. Data from this smaller sample were used to develop a model of condom use behavior based on intentions (as per the TPB) and the additional sub-population relevant constructs. Analyses generally supported the validity of the TPB in this context for predicting intentions and behavior. HIV knowledge and positive outlook (self-esteem and future optimism) were significantly related to TPB predictors of intentions. Intentions, acceptance of sexuality, and gender were significant predictors of behavior. Implications for the status of the TPB and the design of interventions for South African adolescents are discussed.
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Notes
The system of apartheid, which ended in 1994, legally required that South Africans be identified by race and reside in areas or townships reserved only for members of their specific race. In the post apartheid era most South Africans continue to live in racially homogeneous areas. The term “colored” refers to persons of mixed race and Khoisan descent, who during the apartheid era were classified as neither White nor Black.
References
Aiken, L. S., Stein, J. A., and Bentler, P. M. (1994). Structural equation analyses of clinical subpopulation differences and comparative treatment outcomes: Characterizing the daily lives of drug addicts. Journal of Consulting and Clinical Psychology, 62, 488–499.
Aiken, L. S., and West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.
Ajzen, I., and Madden, T. (1986). Prediction of goal-directed behavior: Attitudes, intentions, and perceived behavioral control. Journal of Experimental Social Psychology, 22, 453–474.
Akande, A. (2001). Risky Business: South African youths and HIV/AIDS prevention. Educational Studies, 27, 237–256.
Albarracin, D., Johnson, B. T., Fishbein, M., and Muellerleile, P. A. (2001). Theories of reasoned action and planned behavior as models of condom use: A meta-analysis. Psychological Bulletin, 127, 142–161.
Albarracin, D., Kumkale, G. T., and Johnson, B. (2004). Influences of social power and normative support on condom use decisions: A Research synthesis. AIDS Care, 16, 700–723.
Bandura, A. (1992). A social cognitive approach to the exercise of control over AIDS infection. In R.J. DiClemente (Ed.), Adolescents and AIDS: A Generation in Jeopardy. Newbury Park, CA: Sage.
Bentler, P. M. (1995). EQS: Structural Equations Program Manual. Multivariate Software, Inc.: Encino, CA.
Bryan, A. D., Aiken, L. S., and West, S. G. (1996). Increasing condom use: Evaluation of a theory-based intervention to decrease sexually transmitted disease in women. Health Psychology, 15, 371–382.
Bryan, A. D., Aiken, L. S., and West, S. G. (1997). Young women’s condom use: The influence of responsibility for sexuality, control over the sexual encounter and perceived susceptibility to common STDs. Health Psychology, 16, 468–479.
Bryan, A. D., Aiken, L. S., and West, S. G. (1999). The impact of males’ proposing condom use on perceptions of an initial sexual encounter. Personality and Social Psychology Bulletin, 25, 268–275.
Bryan, A., Aiken, L. S., and West, S. G. (2004). HIV/STD risk among incarcerated adolescents: Optimism about the future and self-esteem as predictors of condom use self-efficacy. Journal of Applied Social Psychology, 34, 912–936.
Bryan, A., Rocheleau, C. A., Robbins, R. N., and Hutchison, K. E. (2005). Condom use among high-risk adolescents: Testing the influence of alcohol use on the relationship of cognitive correlates of behavior. Health Psychology, 24, 133–142.
Bryan, A., Ruiz, M. A., and O’Neill, D. (2003). HIV-related behaviors among prison inmates: A Theory of Planned Behavior analysis. Journal of Applied Social Psychology, 33, 2565–2586.
Bryan, A. D., Schindeldecker, M. S., and Aiken, L. S. (2001). Sexual self-control and male condom-use outcome beliefs: Predicting heterosexual men’s condom use. Journal of Applied Social Psychology, 31, 1911–1938.
Campbell, C. (2003). Letting them die: How HIV/AIDS prevention programmes often fail. Bloomington, IN: Indiana University Press.
Cohen, J. (1988). Statistical power analyses for the behavioral sciences. (2ndEd.). Hillsdale, NJ: Lawrence Erlbaum.
Conner, M., Flesch, D. (2001). Having casual sex: Additive and interactive effects of alcohol and condom availability on the determinants of intentions. Journal of Applied Social Psychology, 31, 89–112.
Department of Health (2002), Medical Research Council and Measure DHS+. South Africa Demographic and Health Survey. Department of Health: Pretoria.
Diener, E., and Seligman, M. E. P. (2004). Beyond money: Toward an economy of well-being. Psychological Science in the Public Interest, 5, 1–31.
Dunkle, K. L., Jewkes, R. K., Brown, H. C., Gray, G. E., McIntryre, J. A., and Harlow, S. D. (2004). Gender-based violence, relationship power, and risk of HIV infection in women attending entenatal clinics in South Africa. Lancet, 363, 1415–1421.
Eaton, L., Flisher, A. J., and Aaro, L. E. (2003). Unsafe sexual behavior in South African youth. Social Science and Medicine, 56, 149–165.
Fisher, J. D., and Fisher, W. A. (1992). Changing AIDS risk behavior. Psychological Bulletin, 111, 455–474.
Fisher, J. D., and Fisher, W. A. (2000). Theoretical approaches to individual-level change. In J. Peterson and R. DiClemente (Eds.), HIV Prevention Handbook (pp. 3–55). New York: Kluwer Academic/Plenum Press.
Fisher, J. D., and Fisher, W. A. (2002). The Information-Motivation-Behavioral Skills Model. In R. DiClemente, R. Crosby and M. Kegler (Eds.), Emerging Promotion Research and Practice. San Francisco, CA: Jossey Bass Publishers.
Fisher, J. D., Fisher, W. A., Bryan, A. D., and Misovich, S. J. (2002). Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth. Health Psychology, 21(2), 177–186.
Gallant, M., and Maticka-Tyndale, E. (2004). School-based HIV prevention programmes for African youth. Social Science and Medicine, 58, 1337–1351.
Jemmott, J. B., Jemmott, L. S., and Fong, G. T. (1998). Abstinence and safer sex HIV risk-reduction interventions for African American adolescents. Journal of the American Medical Association, 279, 1529–1536.
Jewkes, R. K., Levin, J. B., Penn-Kekana, L. A. (2003). Gender inequalities, intimate partner violence and HIV preventive practices: Findings of a South African cross-sectional study. Social Science and Medicine, 56, 125–134.
Jewkes, R., Vundule, C., Maforah, F., and Jordaan, E. (2001). Relationship dynamics and teenage pregnancy in South Africa. Social Science and Medicine, 52, 733–744.
Karim, A. S. S., Karim, A. Q., Preston-Whyte, E., and Sankar, N. (1992). Reasons for lack of condom use among high school students. South African Medical Journal, 92, 107–110.
MacCallum, R. C. (1995). Model specification: Procedures, strategies and related issues. In R.H. Hoyle (Ed.), Structural Equation Modeling: Concepts, Issues, and Applications (pp. 16–36). Thousand Oaks, CA: Sage.
Madu, S. N., and Peltzer, K. (2003). Factor structure of condom attitudes among black South African university students. Social Behavior and Personality, 31, 265–274.
National Institute of Mental Health (NIMH) Multisite HIV Prevention Trial Group (1998). The NIMH multisite HIV prevention trial: Reducing HIV sexual risk behavior. Science, 280, 1889–d information in our theoretical model of intentions, as a putative correlate of attitudes and of 1894.
Shisana, O., and Simbaya, L. (2002). South African national HIV prevalence, behavioral risks and mass media household survey 2002. Cape Town: Human Sciences Researchd information in our theoretical model of intentions, as a putative correlate of attitudes and of Council.
Simbayi, L. C., Chauveau, J., and Shisana, O. (2004). Behavioural responses of South African youth to the HIV/AIDS epidemic: A nationwide survey. AIDS Care, 16, 605–618.
Taylor, M., Dlamini, S. B., Kagoro, H., Jinabhai, C. C., and de Vries, H., (2003). Understanding high school students’ risk behaviors to help reduce the HIV/AIDS epidemic in KwaZulu-Natal, South Africa. Journal of School Health, 73, 97–100.
World Bank. (2000). Intensifying action against HIV/AIDS: Responding to the development crisis. Washington, D.C.: World Bank.
World Health Organization. (1998). Acquired Immunodeficiency Syndrome (AIDS), Weekly Epidemiological Record, 74, 245–251.
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Bryan, A., Kagee, A. & Broaddus, M.R. Condom Use Among South African Adolescents: Developing and Testing Theoretical Models of Intentions and Behavior. AIDS Behav 10, 387–397 (2006). https://doi.org/10.1007/s10461-006-9087-5
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DOI: https://doi.org/10.1007/s10461-006-9087-5