Educational interventions aimed at increasing condom use in high risk groups have met with limited success. Five psychological models developed or modified for HIV risk reduction include: the Transtheoretical Model of Change (TMC), the AIDS Risk Reduction Model (ARRM), Social Cognitive Theory (SCT), the Theory of Reasoned Action (TRA), and the Theory of Planned Behavior (TPB). This longitudinal study examined changes in condom use as a function of variables selected from these theories. Seventy-eight not-in-treatment crack smokers or drug injectors were given a comprehensive risk assessment and the 'stages of change' questionnaire. Change in condom use was dichotomized to indicate reduced risk versus increased or no change in risk. Stepwise logistic regression analysis indicated that higher condom assertiveness, self-reported intention to start using condoms in the next six months, and having multiple sexual partners predicted reductions in unprotected sex at the 6 month follow-up. The disadvantages of condom use, type of drug use (IDU-nonIDU), perceived chance of catching the AIDS virus, ethnicity, gender, age, and intervention type, did not enter into the regression equation. Path models suggest that the best fit model supports a combination of the Theory of Planned Behavior and Social Cognitive Theory in which assertiveness mediates the effect of intention on behavior change. Further research is needed to examine the effects of interventions that target specific components of this model, as well as examining subjects from urban, and higher prevalence sites.
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Health(social science)
- Public Health, Environmental and Occupational Health