Journal of Community Health

, Volume 39, Issue 4, pp 712–718 | Cite as

Predictors of Intention to Use Condoms Among Chinese College Students

  • Ruiling Guo
  • Willis J. McAleese
  • Karen M. Appleby
  • Jianhui Guo
  • Wei Zhang
  • Yi Huang
  • Teri Peterson
Original Paper

Abstract

China is experiencing one of the fastest growing human immunodeficiency virus (HIV) epidemics in the world. Condom use is consistently low among Chinese college students. The purpose of this study was to identify the predictors that determine the intention to use condoms among Chinese college students applying the theory of planned behavior (TPB). A non-probability convenience sample of 433 participants was drawn from three universities in Central, Eastern, and Southwestern China, respectively. An anonymous written questionnaire was self-administered. Data were collected and analyzed descriptively and statistically using Predictive Analytical Software 19.0. Multiple linear regression was performed to identify the predictors among 402 participants with non-missing data. Eighteen percent (78/433) of the participants reported being sexually active in the past 6 months. The percentage of times these individuals reported using condoms during intercourse was 38.19 %. Intention to use condoms was statistically significantly (R2 = 50.4 %) predicted by attitudes (β = 0.213), subjective norms (β = 0.259), and perceived behavior control (PBC) (β = 0.332). All predictors were statistically significant at the 0.001 level (p < 0.001). PBC was the strongest predictor of intention to use condoms. The study findings indicated that the TPB could be used as a framework to determine the predictors of intention to use condoms among the Chinese college students. It is recommended that the HIV education programs should increase the intention to use condoms through promoting positive attitudes, subjective norms and PBC of condom use in Chinese college students.

Keywords

Condom use Human immunodeficiency virus Theory of planned behavior Sexual behavior Chinese college students 

References

  1. 1.
    Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In J. Kuhl & J. Beckman (Eds.), Action control: From cognition to behavior (pp. 11–39). New York, NY: Springer-Verlag.CrossRefGoogle Scholar
  2. 2.
    Ajzen, I. (1988). Attitudes, personality, and behavior. Chicago, IL: The Dorsey Press.Google Scholar
  3. 3.
    Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.CrossRefGoogle Scholar
  4. 4.
    Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  5. 5.
    Albarracin, D., Johnson, B. T., Fishbein, M., & Muellerleile, P. A. (2001). Theories of reasoned action and planned behavior as models of condom use: A meta-analysis. Psychological Bulletin, 127, 142–161.PubMedCrossRefGoogle Scholar
  6. 6.
    Behling, O., & Law, K. S. (2000). Translating questionnaires and other research instruments: Problems and solutions (p. 23). Thousand Oaks, CA: Sage Publications.Google Scholar
  7. 7.
    Bennett, P., & Bozionelos, G. (2000). The theory of planned behavior as predictor of condom use: A narrative review. Psychology, Health and Medicine, 5, 307–326.CrossRefGoogle Scholar
  8. 8.
    Boer, H., & Mashamba, M. T. (2007). Gender power imbalance and differential psychosocial correlates of intended condom use among male and female adolescents from Venda, South Africa. British Journal of Health Psychology, 12, 51–63. doi:10.1007/s10935-0199-3.PubMedCrossRefGoogle Scholar
  9. 9.
    Bryan, A., Fisher, J. D., & Fisher, W. A. (2002). Tests of the mediational role of preparatory safer sexual behavior in the context of the theory of planned behavior. Health Psychology, 21, 71–80.PubMedCrossRefGoogle Scholar
  10. 10.
    Bryan, A., Kagee, A., & Broaddus, M. R. (2006). Condom use among South African adolescents: Developing and testing theoretical models of intentions and behavior. AIDS and Behavior, 10, 387–397. doi:10.1007/s10461-9087-5.PubMedCrossRefGoogle Scholar
  11. 11.
    Carmack, C. C., & Lewis-Moss, R. K. (2009). Examining the theory of planned behavior applied to condom use: The effect-indicator vs. causal-indicator models. Journal of Primary Prevention, 30, 659–676. doi:10.1007/s10935-0199-3.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Cha, E. S., Kim, K. H., & Patrick, T. E. (2008). Predictors of intention to practice safer sex among Korean college students. Archives of Sexual Behavior, 37, 641–651.PubMedCrossRefGoogle Scholar
  13. 13.
    Grusky, O., Liu, H. J., & Johnston, M. (2002). HIV/AIDS in China 1990–2001. AIDS and Behavior, 6, 381–393.CrossRefGoogle Scholar
  14. 14.
    Gu, J., Lau, J. T., Chen, X., Liu, C., Liu, J., Chen, H., et al. (2009). Using the theory of planned behavior to investigate condom use behaviors among female injecting drug users who are also sex workers in China. AIDS Care, 21, 967–975.PubMedCrossRefGoogle Scholar
  15. 15.
    Heeren, G. A., Jemmott, J. B., Mandeya, A., & Tyler, J. C. (2007). Theory-based predictors of condom use among university students in the United States and South Africa. AIDS Education and Prevention, 19, 1–12.PubMedCrossRefGoogle Scholar
  16. 16.
    Huang, J., Bova, C., Fennie, K. P., Rogers, A., & Williams, A. B. (2005). Knowledge, attitudes, behaviors, and perceptions of risk related to HIV/AIDS among Chinese university students in Hunan, China. AIDS Patient Care and STDs, 19, 769–777.PubMedCrossRefGoogle Scholar
  17. 17.
    Jamner, M. S., Wolitski, R. J., Corby, N. H., & Fishbein, M. (1998). Using the theory of planned behavior to predict intention to use condoms among female sex workers. Psychology and Health, 13, 187–205. doi:10.1080/08870449808406746.CrossRefGoogle Scholar
  18. 18.
    Janepanish, P. (2009). Consistent condom use among Thai young adult males: An application of Theory of Planned Behavior (Doctoral dissertation). Dissertations & Theses, A&I. (UMI No. 3364815).Google Scholar
  19. 19.
    Johnson, B. L., von Haeften, I., Fishbein, M., Kasprzyk, D., & Montano, D. (2001). Factors influencing IDU and non-IDU female commercial sex workers’ intentions to always use condoms for vaginal sex with their regular partner. Psychology, Health and Medicine, 6, 207–222. doi:10.1080/13548500123901.CrossRefGoogle Scholar
  20. 20.
    Ma, Q., Ono-Kihara, M., Cong, L., Pan, X., Xu, G., Zamani, S., et al. (2009). Behavioral and psychosocial predictors of condom use among university students in Eastern China. AIDS Care, 21, 249–259.PubMedCrossRefGoogle Scholar
  21. 21.
    Macalino, G. E., Sachdev, D. D., Rich, J. D., Becker, C., Tan, L. J., Beletsky, L., et al. (2009). A national physician survey on prescribing syringes as an HIV prevention. Substance Abuse Treatment, Prevention, and Policy, 8, 4–13. doi:10.1186/1747-597X-4-13.Google Scholar
  22. 22.
    Mausbach, B. T., Semple, S. J., Strathdee, S. A., & Patterson, T. L. (2009). Predictors of safer sex intentions and protected sex among heterosexual HIV-negative methamphetamine users: An expanded model of the theory of planned behavior. AIDS Care, 21, 17–24.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Ministry of Health, UNAIDS, & World Health Organization. (2010). 2009 estimates for the HIV/AIDS epidemic in China. Retrieved July 20, 2010. http://www.unaids.org.cn/download/2009%20China%20Estimation%20Report-En.pdf.
  24. 24.
    Molla, M., Astrom, A. N., & Brehane, Y. (2007). Applicability of the theory of planned behavior to intended and self-reported condom use in a rural Ethiopian population. AIDS Care, 19, 425–431.PubMedCrossRefGoogle Scholar
  25. 25.
    Munoz-Silva, A., Sanchez-Garcia, M., Martins, A., & Nunes, C. (2009). Gender differences in HIV-related sexual behavior among college students from Spain and Portugal. The Spanish Journal of Psychology, 12, 485–495.PubMedCrossRefGoogle Scholar
  26. 26.
    Nucifora, J., Gallois, C., & Kashima, Y. (1993). Influences on condom use among undergraduates: Testing the theories of reasoned action and planned behavior. In D. J. Terry, C. Gallois, & M. McCamish (Eds.), Theory of reasoned action: Its application to AIDS-preventive behavior (pp. 47–64). Oxford, England: Pergamon.Google Scholar
  27. 27.
    Qi, X. (2002). HIV/AIDS epidemiology and China five-year action plan and research. Beijing, China: The First Sino-US conference on research and training in AIDS-related areas.Google Scholar
  28. 28.
    Rannie, K., & Craig, D. (1997). Adolescent females’ attitudes, subjective norms, perceived behavioral control and intentions to use latex condoms. Public Health Nursing, 14, 51–57.PubMedCrossRefGoogle Scholar
  29. 29.
    Sheeran, P., Abraham, C., & Orbell, S. (1999). Psychosocial correlates of heterosexual condom use: A meta-analysis. Psychological Bulletin, 125, 90–132.PubMedCrossRefGoogle Scholar
  30. 30.
    Sheeran, P., & Taylor, S. (1999). Predicting intentions to use condoms: A meta-analysis and comparison of the theories of reasoned action and planned behavior. Journal of Applied Social Psychology, 29, 1624–1675. doi:10.1111/j.1559-1816.1999.tb02045.x.CrossRefGoogle Scholar
  31. 31.
    Sheng, L., & CAO, W. K. (2008). HIV/AIDS epidemiology and prevention in China. Chinese Medical Journal (Eng), 121, 1230–1236.Google Scholar
  32. 32.
    Wang, L., Wang, N., Wang, L., Li, D., Jia, M., Gao, X., et al. (2009). The 2007 estimates for people at risk for and living with HIV in China: Progress and challenges. Journal of Acquired Immune Deficiency Syndrome, 50, 414–418.CrossRefGoogle Scholar
  33. 33.
    Webber, G. C. (2007). Chinese health care providers’ attitudes about HIV: A review. AIDS Care, 19, 685–691.PubMedCrossRefGoogle Scholar
  34. 34.
    Wise, D., Goggin, K., Gerkovich, M., Metcalf, K., & Kennedy, S. (2006). Predicting intentions to use condoms using gender, sexual experience, and the theory of planned behavior. American Journal of Health Education, 37, 210–218.CrossRefGoogle Scholar
  35. 35.
    Wolitski, R. J., & Zhang, J. (2007). Understanding and motivating condom use among at-risk and HIV-seropositive persons: A review and demonstration of the applicability of the theories of reasoned action and planned behavior. In I. Ajzen, D. Albarracín, & R. Hornik (Eds.), Prediction and change of health behavior: Applying the reasoned action approach (pp. 173–196). Mahwah, NJ: Lawrence Erlbaum Associates Publishers.Google Scholar
  36. 36.
    Xiao, Z., Palmgreen, P., Zimmerman, R., & Noar, S. (2010). Adapting and applying a multiple domain model of condom use to Chinese college students. AIDS Care, 22, 332–338. doi:10.1016/j.socscimed.2006.09.019.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Ruiling Guo
    • 1
  • Willis J. McAleese
    • 2
  • Karen M. Appleby
    • 3
  • Jianhui Guo
    • 4
  • Wei Zhang
    • 5
    • 6
  • Yi Huang
    • 7
  • Teri Peterson
    • 8
  1. 1.Idaho Health Sciences LibraryIdaho State UniversityPocatelloUSA
  2. 2.Kasiska School of Health ProfessionsIdaho State UniversityPocatelloUSA
  3. 3.Department of Sport Science and Physical EducationIdaho State UniversityPocatelloUSA
  4. 4.Department of Physical EducationHenan Institute of EducationZhengzhouChina
  5. 5.Shandong Center for Disease Control and PreventionJinanChina
  6. 6.School of Public HealthShandong UniversityJinanChina
  7. 7.Chengdu University of TechnologyChengduChina
  8. 8.College of BusinessIdaho State UniversityPocatelloUSA

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