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AIDS and Behavior

, 12:913 | Cite as

Adolescent Sexual Risk: Factors Predicting Condom Use Across the Stages of Change

  • Cynthia Grossman
  • Wendy Hadley
  • Larry K. Brown
  • Christopher D. Houck
  • April Peters
  • Marina Tolou-Shams
  • Project SHIELD Study Group
Original Paper

Abstract

This study examined factors associated with high-risk adolescents’ movement toward or away from adopting consistent condom use behavior using the Transtheoretical Model Stages of Change. Participants drawn from the inactive comparison condition of a randomized HIV prevention trial (Project SHIELD) responded to items assessing pros and cons of condom use, peer norms, condom communication, and perceived invulnerability to HIV. Participants were categorized based on their condom use behavior using the Transtheoretical Model. Multiple logistic regressions found that progression to consistent condom use was predicted by continuing to perceive more advantages to condom use, reporting greater condom use communication with partners, and less perceived invulnerability to HIV. Movement away from adopting consistent condom use was predicted by a decrease in perceived advantages to condom use, increased perceived condom disadvantages, and fewer condom discussions. Future interventions may be tailored to enhance these factors that were found to change over time.

Keywords

Adolescent Sexual risk behavior Stages of change Condom use 

Notes

Acknowledgment

Research supported by SAMHSA grant U10 SMS2073 to the cooperating sites: Rhode Island Hospital, Miriam Hospital, Emory University, and University of Miami.

References

  1. Armitage, C. J., Sheeran, P., Conner, M., & Arden, M. A. (2004). Stages of change or changes of stage? Predicting transitions in transtheoretical model stages in relation to healthy food choice. Journal of Consulting & Clinical Psychology, 72, 491–499.CrossRefGoogle Scholar
  2. Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.PubMedCrossRefGoogle Scholar
  3. Bandura, A. (1982). Self efficacy mechanism in human agency. American Psychologist, 37, 122–147.CrossRefGoogle Scholar
  4. Bowen, A. M., & Trotter, R. (1995). HIV risk in intravenous drug users and crack cocaine smokers: Predicting stage of change for condom use. Journal of Consulting & Clinical Psychology, 63, 238–248.CrossRefGoogle Scholar
  5. Brown, L. K., Schultz, J. R., Parsons, J. T., Butler, R. B., Forsberg, A. D., Kocik, S. M., et al. (2000). Sexual behavior change among HIV infected adolescents with hemophilia. Pediatrics, 106, E22.PubMedCrossRefGoogle Scholar
  6. Cabral, R. J., Galavotti, C., Stark, M. J., Gargiullo, P. M., Semaan, S., Adams, J., et al. (2004). Psychosocial factors associated with stage of change for contraceptive use among women at increased risk for HIV and STDs. Journal of Applied Social Psychology, 34, 959–983.CrossRefGoogle Scholar
  7. Courneya, K. S., Plotnikoff, R. C., Hotz, S. B., & Birkett, N. J. (2001). Predicting exercise stage transitions over two consecutive 6-month periods: A test of the theory of planned behaviour in a population-based sample. British Journal of Health Psychology, 6, 135–150.PubMedCrossRefGoogle Scholar
  8. Crosby, R. A., DiClemente, R. J., Wingood, G. M., Salazar, L. F., Harrington, K., Davies, S. L., et al. (2003). Identification of strategies for promoting condom use: A prospective analysis of high-risk African American female teens. Prevention Science, 4, 263–270.PubMedCrossRefGoogle Scholar
  9. Crosby, R., DiClemente, R. J., Wingood, G. M., Salazar, L. F., Rose, E., Levine, D., et al. (2005). Condom failure among adolescents: Implications for STD prevention. Journal of Adolescent Health, 36, 534–536.PubMedCrossRefGoogle Scholar
  10. Everett, S. A, Warren, C. W., Santelli, J. S., Kann, L., Collins, J. L., & Kolbe, L. J. (2000). Use of birth control pills, condoms, and Withdrawal among US high school students. Journal of Adolescent Health, 27, 112–118.PubMedCrossRefGoogle Scholar
  11. Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention and behavior: An introduction to theory and research. London: Addison Wesley.Google Scholar
  12. Fortenberry, J. D., Tu, W., Harezlak, J., Katz, B. P., & Orr, D. P. (2002). Condom use as a function of time in new and established adolescent sexual relationships. American Journal of Public Health, 92, 211–213.CrossRefGoogle Scholar
  13. Grimley, D. M., Prochaska, J. O., Velicer, W. F., Blais, L., & DiClemente, C. C. (1994). The transtheoretical model of change. In T. Brinthaupt & R. Lipka (Eds.), Changing the self: Philosophies, techniques and experiences (pp. 201–227). Albany, NY: State University of New York Press.Google Scholar
  14. Grimley, D. M., 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.PubMedGoogle Scholar
  15. Hacker, K., Brown, E., Cabral, H., & Dodds, D. (2005). Applying a transtheoretical behavioral change model to HIV/STD and pregnancy prevention in adolescent clinics. Journal of Adolescent Health, 37, S80–S93.PubMedCrossRefGoogle Scholar
  16. Janis, I. L., & Mann, L. (1977). Decision making: A psychological analysis of conflict, choice and commitment. New York: Free Press.Google Scholar
  17. Ku, L., Sonenstein, F. L., & Pleck, J. H. (1993). Factors influencing first intercourse for teenage men. Public Health Report, 108, 680–694.Google Scholar
  18. Lescano, C., Vazquez, E. A., Brown, L. K., Litvin, E., Pugatch, D., & Project SHIELD Study Group. (2006). Condom use with “Casual” and “Main” Partners: What’s in a Name? Journal of Adolescent Health, 39, 443.PubMedCrossRefGoogle Scholar
  19. Malotte, C. K., Jarvis, B., Fishbein, M., Kamb, M., Iatesta, M., Hoxworth, T., et al. (2000). Stage of change versus an integrated psychosocial theory as a basis for developing effective behaviour change interventions. AIDS Care, 12, 357–364.PubMedCrossRefGoogle Scholar
  20. Marsiglio, W. (1993). Adolescent males’ orientation toward paternity and contraception. Family Planning Perspectives, 25, 22–31.PubMedCrossRefGoogle Scholar
  21. NIMH Multisite HIV Prevention Trial Group. (1998). The NIMH multisite HIV prevention trial: Reducing HIV sexual risk behavior. Science, 280, 1889–1894.CrossRefGoogle Scholar
  22. Office of National AIDS Policy. (2000). Youth and HIV/AIDS 2000: A new American agenda. Washington, DC: The White House.Google Scholar
  23. Polacsek, M., Celentano, D., O’Campo, P., & Santelli, J. (1999). Correlates of condom use stage of change: Implications for interventions. AIDS Education and Prevention, 11, 38–52.PubMedGoogle Scholar
  24. Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: toward an integrative model of change. Journal of Consulting & Clinical Psychology, 51, 390–395.CrossRefGoogle Scholar
  25. 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.PubMedCrossRefGoogle Scholar
  26. Prochaska, J. O., Redding, C. A., 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.PubMedGoogle Scholar
  27. Santelli, J. S., Kaiser, J., Hirsch, L., Radosh, A., Simkin, L., & Middlesteadt, S. (2004). Initiation of sexual intercourse among middle school adolescents: The influence of psychosocial factors. Journal of Adolescent Health, 34, 200–208.PubMedGoogle Scholar
  28. Schnell, D., Galavotti, C., Fishbein, M., & Chan, D. (1996). Measuring the adoption of consistent use of condoms using the stages of change model. Public Health Reports, 111, 59–68.PubMedGoogle Scholar
  29. Schumann, A., Meyer, C., Rumpf, H., Hannover, W., Hapke, U., & John, U. (2005). Stage of change transitions and processes of change, decisional balance, and self-efficacy in smokers: A transtheoretical model of validation using longitudinal data. Psychology of Addictive Behaviors, 19, 3–9.PubMedCrossRefGoogle Scholar
  30. Sieving, R., Eisenberg, M., Pettingell, S., & Skay, C. (2006). Friends’ influence on adolescents’ first sexual intercourse. Perspectives on Sexual and Reproductive Health, 38, 13–19.PubMedCrossRefGoogle Scholar
  31. 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 & Clinical Psychology, 66, 967–978.CrossRefGoogle Scholar
  32. Velicer, W. F., DiClemente, C. C., Prochaska, J. O., & Brandenberg, N. (1985). Decisional balance measurement for assessing and predicting smoking status. Journal of Personality and Social Psychology, 48, 1279–1289.PubMedCrossRefGoogle Scholar
  33. Weinstock, H., Berman, S., & Cates, W. (2004). Sexually transmitted diseases among American youth: Incidence and prevalence estimates 2000. Perspectives on Sexual and Reproductive Health, 36, 6–10.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Cynthia Grossman
    • 1
  • Wendy Hadley
    • 2
  • Larry K. Brown
    • 2
  • Christopher D. Houck
    • 2
  • April Peters
    • 2
  • Marina Tolou-Shams
    • 2
  • Project SHIELD Study Group
    • 3
  1. 1.National Institute of Mental HealthBethesdaUSA
  2. 2.Rhode Island HospitalBrown Medical School ProvidenceUSA
  3. 3. ProvidenceUSA

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