Skip to main content
Log in

Condom Use Among South African Adolescents: Developing and Testing Theoretical Models of Intentions and Behavior

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Notes

  1. 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

  1. 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.

    Article  PubMed  CAS  Google Scholar 

  2. Aiken, L. S., and West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.

    Google Scholar 

  3. 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.

    Article  Google Scholar 

  4. Akande, A. (2001). Risky Business: South African youths and HIV/AIDS prevention. Educational Studies, 27, 237–256.

    Article  Google Scholar 

  5. 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.

    Article  PubMed  CAS  Google Scholar 

  6. 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.

    Article  PubMed  CAS  Google Scholar 

  7. 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.

    Google Scholar 

  8. Bentler, P. M. (1995). EQS: Structural Equations Program Manual. Multivariate Software, Inc.: Encino, CA.

    Google Scholar 

  9. 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.

    Article  PubMed  CAS  Google Scholar 

  10. 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.

    Article  PubMed  CAS  Google Scholar 

  11. 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.

    Article  Google Scholar 

  12. 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.

    Article  Google Scholar 

  13. 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.

    Article  PubMed  Google Scholar 

  14. 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.

    Article  Google Scholar 

  15. 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.

    Article  Google Scholar 

  16. Campbell, C. (2003). Letting them die: How HIV/AIDS prevention programmes often fail. Bloomington, IN: Indiana University Press.

    Google Scholar 

  17. Cohen, J. (1988). Statistical power analyses for the behavioral sciences. (2ndEd.). Hillsdale, NJ: Lawrence Erlbaum.

    Google Scholar 

  18. 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.

    Article  Google Scholar 

  19. Department of Health (2002), Medical Research Council and Measure DHS+. South Africa Demographic and Health Survey. Department of Health: Pretoria.

  20. 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.

    Article  Google Scholar 

  21. 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.

    Article  PubMed  Google Scholar 

  22. Eaton, L., Flisher, A. J., and Aaro, L. E. (2003). Unsafe sexual behavior in South African youth. Social Science and Medicine, 56, 149–165.

    Article  PubMed  Google Scholar 

  23. Fisher, J. D., and Fisher, W. A. (1992). Changing AIDS risk behavior. Psychological Bulletin, 111, 455–474.

    Article  PubMed  CAS  Google Scholar 

  24. 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.

    Google Scholar 

  25. 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.

    Google Scholar 

  26. 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.

    Article  PubMed  Google Scholar 

  27. Gallant, M., and Maticka-Tyndale, E. (2004). School-based HIV prevention programmes for African youth. Social Science and Medicine, 58, 1337–1351.

    Article  PubMed  Google Scholar 

  28. 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.

    Article  PubMed  Google Scholar 

  29. 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.

    Article  PubMed  Google Scholar 

  30. 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.

    Article  PubMed  CAS  Google Scholar 

  31. 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.

    Google Scholar 

  32. 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.

    Google Scholar 

  33. 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.

    Article  Google Scholar 

  34. 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.

    Article  Google Scholar 

  35. 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.

  36. 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.

    Article  PubMed  CAS  Google Scholar 

  37. 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.

    Article  PubMed  CAS  Google Scholar 

  38. World Bank. (2000). Intensifying action against HIV/AIDS: Responding to the development crisis. Washington, D.C.: World Bank.

    Google Scholar 

  39. World Health Organization. (1998). Acquired Immunodeficiency Syndrome (AIDS), Weekly Epidemiological Record, 74, 245–251.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-006-9087-5

Key Words

Navigation