Application of an Integrated Behavioral Model to Predict Condom Use: A Prospective Study Among High HIV Risk Groups1

Abstract

An integrated theoretical model using constructs from multiple behavioral models was applied to understand and predict condom use among a sample of injecting drug users, commercial sex workers, men who have sex with men, and multipartnered heterosexuals. Elicitation interviews were conducted to develop a questionnaire to measure model constructs that may be predictive of condom use for sex with vaginal, anal, and oral regular and casual partners. A prospective survey design was used, with 993 participants interviewed at Time 1, and 686 returning for Time 2 interviews 3 months later. Regression analyses were conducted using Time 1 measures to predict intention and Time 2 behavior. Strong support was found for a model that includes attitude, social norm, and facilitators/constraints as predictors of behavior, with multiple correlations in the 0.20 to 0.40 range. Findings also indicate perceived control and facilitators/constraints are distinct constructs and both, along with attitude and social norm, contribute to explaining behavioral intention. Implications for intervention development are discussed.