Contraceptive and Condom Use for the Prevention of Pregnancy, STDs, and AIDS: A Transtheoretical Approach

Abstract

This research involved three independent sample with over 600 heterosexually active individuals and examines the applicability of the Transtheoretical Model of Behavior Change to contraceptive and condom use behavior. The pilot study involved 123 college men and women. Measures representing two of the major constructs from the model, stages of change and decisional balance, were developed for general contraceptive and condom use. The second investigation was a measurement study conducted in collaboration with the Centers for Disease Control and Prevention (CDC), and consisted of 238 impoverished women at high risk for HIV infection or transmission. Measures and models for specific methods of contraception were developed for the stages of change, decisional balance, self-efficacy, and the processes of change for condom use. Lastly, the third sample involved college-age men and women (N = 248) which cross-validated the measures developed with high risk women. A measure for the processes of change for birth control use was included, as well as several additional measures – sexual assertiveness, perceived risk, sexual abuse. Overall, the findings support the applicability of the Transtheoretical Model to contraceptive and condom use behavior across alternative samples. The major findings include: a general measure could be employed when examining hormonal methods of birth control, whereas condom use needs to be model separately with main and other partners; both populations were further along in the stages for pregnancy prevention, as compared with disease prevention; individuals were further along for using condoms with casual partners, as compared with main partners; individuals in the precontemplation stage had significantly lower pros scores for both pregnancy and disease prevention – the opposite was true for those in the maintenance stage; the pros and cons cross-over occurred in either contemplation or preparation; self-efficacy is the lowest in the precontemplation stage and continues to climb with further movement through the stages; the construct of sexual assertiveness provided unique information regarding condom use; two measures assessing the processes of change (general birth control/condom use) demonstrated that experiential processes peaked in the preparation stage and the use of the behavioral processes (e.g. stimulus control) continued to climb into the maintenance stage; and, although men and women did not differ on current use or intention to use contraceptives/condoms, distinct sex differences were found for the other model constructs and sexual assertiveness.