Abstract
This study examined how condom use attitude, self-efficacy, and partner intimacy related to five stages of consistent condom use. Interview data were collected from sexually active, heterosexual, African-American crack cocaine smokers (N = 366). Dependent measures assessed both the participants’ own responses and their perceptions about their last sex partner’s own personal condom use attitude and participants’ condom use self-efficacy expectations. Partner intimacy was assessed both as a continuous attitudinal and as a discrete relationship measure. Less than 10% were classified as consistent condom users. Two thirds of inconsistent users were in the Precontemplation (PC) stage. The contemplation (C) and preparation (P) stages were equal among the remainder of the inconsistent condom users. Higher partner intimacy reduced modestly readiness for consistent condom use. The stage but not the intimacy group was related to the condom use attitudes and self-efficacy measures. Last partners’ perceived own negative attitudes were significantly related to the stages of consistent condom use and was especially low in the action (A) and maintenance (M) stages. Participants’ own negative attitudes were unrelated to the stages. Of the self-efficacy measures, both participants’ performance and situational condom use self-efficacies increased significantly after the PC stage and were highest in the P, A, and M stages. However, situational self-efficacy accounted for most of performance self-efficacy variance. In sum, consistent condom use was rare. A partner’s attitudes and the participants’ own situational self-efficacy expectations, rather than intimacy, determined the readiness to adopt consistent condom use.
Similar content being viewed by others
References
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.
Ajzen, I., & Fishbein, M. (2004). Questions raised by a reasoned action approach: Comments on Ogden (2003). Health Psychology, 23, 431–434.
Anderson, J. E., Cheney, R., Faruque, S., Long, A., Toomey, K., & Wiebe, W. (1996). Stages of change for HIV risk behavior: Injection drug users in five cities. Drugs & Society, 9, 1–17.
Anderson, J. E., Wilson, R., Doll, L., Jones, S., & Baker, P. (1999). Condom use and HIV risk behaviors among U.S. adults: Data from a national survey. Family Planning Perspective, 31, 24–28.
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.
Becker, M. H., & Joseph, J. G. (1988). AIDS and behavioral change to reduce risk: A review. American Journal of Public Health, 78, 394–410.
Booth, R. E., Watters, J. K., & Chitwood, D. D. (1993). HIV risk-related sex behaviors among injection drug users, crack smokers, and injection drug users who smoke crack. American Journal of Public Health, 83, 1144–1148.
Bowen, A. M. (1996). Predicting increased condom use with main partners: Potential approaches to intervention. Drugs and Society, 9, 57–74.
Bowen, A., & Trotter, R. (1995). HIV risk in intravenous drug users and crack cocaine smokers: Predicting stage of change for condom use. Journal of Consulting and Clinical Psychology, 63, 238–248.
Brown-Peterside, P., Redding, C. A., Ren, R., & Koblin, B. A. (2000). Acceptability of a stage-matched expert system intervention to increase condom use among women at high risk of HIV infection in New York City. AIDS Education and Prevention, 12, 171–181.
Brunswick, A. F., & Flory, M. J. (1998). Changing HIV infection rates and risk in an African-American community cohort. AIDS Care, 10, 267–281.
Calsyn, D., Meinecke, C., Saxon, A., & Stanton, V. (1992). Risk reduction in sexual behavior: A condom giveaway program in a drug abuse treatment clinic. American Journal of Public Health, 82, 1536–1538.
Catania, J. A., Kegeles, S., & Coates, T. (1990). Towards an understanding of risk behavior: An AIDS risk reduction model (ARRM). Health Education Quarterly, 17, 53–72.
de Visser, R., & Smith, M. (2000). When always isn’t enough: Implications of the late application of condom for the validity and reliability of self-reported condom use. AIDS Care, 12, 221–224.
Desenclos, J., Papaevangelou, G., & Ancelle-Park, R. (1993). Knowledge, HIV serostatus and prevention behaviour among European injecting drug users. AIDS, 7, 1371–1377.
DiClemente, C. C. (1993). Changing addictive behaviors: A process perspective. Current Directions in Psychological Science, 2, 101–106.
Edlin, B. R., Irwin, K. L., Ludwig, D. D., McCoy, H. V., Serrano, Y., Word, C., et al. (1992). High-risk sex behavior among young street-recruited crack cocaine smokers in three American cities: An interim report. Journal of Psychoactive Drugs, 24, 363–371.
Galavotti, C., Cabral, R. J., Lansky, A., Grimley, D., Riley, G. E., & Prochaska, J. O. (1995). Validation of measures of condom and other contraceptive use among women at high risk for HIV infection and unintended pregnancy. Health Psychology, 14, 570–578.
Gorsuch, R. L. (1983). Factor analysis (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.
Grimley, D., Prochaska, J. O., Velicer, W. F., & Prochaska, G. E. (1995). Contraceptive and condom use adoption and maintenance: A stage paradigm approach. Health Education Quarterly, 22, 20–35.
Grimley, D. M., Riley, G. E., Prochaska, J. O., Redding, C. A., Ruggiero, L., Velicer, W. F., et al. (1992). The application of the transtheoretical model to contraceptive and condom use in high-risk women. Atlanta, GA: Centers for Disease Control and Prevention.
Hershberger, S. L., Wood, M. M., & Fisher, D. G. (2003). A cognitive-behavioral intervention to reduce HIV risk behaviors in crack and injection drug users. AIDS and Behavior, 7, 229–243.
Jaccard, J., McDonald, R., Wan, C. K., Dittus, P. J., & Quinlan, S. (2002). The accuracy of self-reports of condom use and sexual behavior. Journal of Applied Psychology, 32, 1863–1905.
Jamner, M. S., Wolitski, R. J., & Corby, N. H. (1997). Impact of a longitudinal community HIV intervention targeting injecting drug users’ stage of change for condom and bleach use. American Journal of Health Promotion, 12, 15–24.
Morris, M. (1993). Telling tails explain the discrepancy in sexual partner reports. Nature, 365, 437–440.
Noar, S. M., Morokoff, P. J., & Redding, C. A. (2002). Sexual assertiveness in heterosexually active men: A test of three samples. AIDS Education and Prevention, 14, 330–342.
Pallonen, U. E., Williams, M. L., Timpson, S. C., Bowen, A., & Ross, M. W. (2008). Personal and partner measures in stages of consistent condom use among African-American heterosexual crack cocaine smokers. AIDS Care, 20, 212–220.
Prochaska, J. O. (1994). Strong and weak principles for progressing from precontemplation to action based on twelve problem behaviors. Health Psychology, 13, 47–56.
Prochaska, J. O., & DiClemente, C. C. (1984). The transtheoretical approach. Homewood, IL: Dow-Jones-Irwin.
Prochaska, J. O., & DiClemente, C. C. (1986). Toward a comprehensive model of change. In W. Miller & N. Heather (Eds.), Treating addictive behaviors (pp. 3–27). New York: Plenum Press.
Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47, 1102–1114.
Prochaska, J. O., Redding, C., Harlow, L. L., Rossi, J. S., & Velicer, W. F. (1994). The transtheoretical model of change and HIV prevention: A review. Health Education Quarterly, 21, 471–486.
Rhodes, F., & Malotte, C. K. (1996). Using stages of change to assess intervention readiness and outcome in modifying drug-related and sexual HIV risk behaviors of IDUs and crack users. Drugs & Society, 9, 109–136.
Riehmann, K., Sly, D., Soler, H., Eberstein, I., Quadagno, D., & Harrison, D. (1998). Dual-methods use among an ethnically diverse group of women at risk of HIV infection. Family Planning Perspectives, 30, 212–216.
Ross, L., Kohler, C. L., Grimley, D. M., & Bellis, J. (2003a). Intention to use condoms among three low-income, urban African American subgroups: Cocaine users, noncocaine drug users, and non-drug users. Journal of Urban Health, 80, 147–160.
Ross, M. W., Timpson, S. C., Williams, M. L., & Bowen, A. M. (2003b). Situational correlates of condom use in a sample of African American drug users who are primarily crack cocaine users. AIDS and Behavior, 7, 55–60.
Sagrestano, L. M., Rogers, A., Kittleson, M. J., & Sarvela, P. D. (2005). Does efficacy mediate stage of change and condom use in injected-drug users? American Journal of Health Behavior, 29, 12–24.
Schnell, D. J., Galavotti, C., Fishbein, M., Chan, D. K.-S., & The AIDS Community Demonstration Projects. (1996). Measuring the adoption of consistent use of condoms using the stage of change model. Public Health Reports, 111(Supp. 1), 59–68.
Stark, M. J., Tesselaar, H. M., O’Connell, A. A., Person, B, Galavotti, C., Cohen, A., et al. (1998). Psychosocial factors associated with the stages of change for condom use among women at risk for HIV and STDs: Implications for intervention development. Journal of Consulting and Clinical Psychology, 66, 967–978.
Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics (4th ed.). Needham Heights, MA: Allyn & Bacon.
Timpson, S., Pollack, K., Bowen, A., Williams, M., Ross, M., McCoy, C., et al. (2001). Gender differences in processes of change for condom use: Patterns across stages of change in crack cocaine users. Health Education Research, 16, 541–553.
Timpson, S. C., Williams, M. L., Bowen, A. M., & Keel, K. B. (2003). Condom use behaviors in HIV-infected African American crack cocaine users. Substance Abuse, 24, 211–220.
Turner, C., & Miller, H. (1997). Zenilman’s anomaly reconsidered: Fallible reports, ceteris paribus, and other hypotheses. Sexually Transmitted Diseases, 24, 522–527.
Wang, M. Q., Collins, C. B., Kohler, C. L., DiClemente, R. J., & Wingood, G. (2000). Drug use and HIV risk-related sex behaviors: A street outreach study of black adults. Southern Medical Journal, 93, 186–190.
Watters, J., & Biernacki, P. (1989). Targeted sampling: Options for the study of hidden populations. Social Problems, 36, 416–430.
Weir, S. S., Roddy, R. E., Zekeng, L., & Ryan, K. A. (1999). Associations between condom use and HIV infection: A randomized study of self reported condom use measures. Journal of Epidemiological Community Health, 53, 417–422.
Williams, M. L., Atkinson, J. S., Klovdahl, A., Ross, M. W., &. Timpson, S. C. (2005). Spatial bridging in a network of male sex workers. Journal of Urban Health, 82, i35–i42.
Williams, M. L., Bowen, A. M., Elwood, W. N., McCoy, C. C., McCoy, H. V., & Freeman, R. C., et al. (2000). Determinants of condom use among African Americans who smoke crack cocaine. Culture, Health, & Sexuality, 2, 15–32.
Wingood, G. M., & DiClemente, R. J. (1998). Partner influences and gender-related factors associated with noncondom use among young adult African American women. American Journal of Community Psychology, 26, 29–51.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pallonen, U.E., Timpson, S.C., Williams, M.L. et al. Stages of Consistent Condom Use, Partner Intimacy, Condom Use Attitude, and Self-Efficacy in African-American Crack Cocaine Users. Arch Sex Behav 38, 149–158 (2009). https://doi.org/10.1007/s10508-008-9391-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10508-008-9391-4