Abstract #245  -  Predicting African American Heterosexual Mens Condom Use: Prospective Data on a Neglected Population
Authors:   Presenting Author:   Dr. John B. Jemmott - University of Pennsylvania
Additional Authors:  Dr. Anita Heeren,
Aim: Although heterosexual exposure is the modal HIV transmission category among people diagnosed with HIV/AIDS worldwide, few gender-specific HIV/STD risk reduction intervention studies have targeted adult mens heterosexual behavior. The development of such interventions requires an understanding of the psychosocial correlates and mediators of men�s sexual risk behavior with women. Here we report a prospective study examining whether the theory of planned behavior could explain intention and condom use among African American men 18 to 45 years of age who reported having vaginal intercourse in the previous 3 months.
Method / Issue: Although the modal HIV transmission category among African American men in the US is male-to-male contact, this study was conducted in Philadelphia, PA, where the modal HIV transmission category among African American men diagnosed with HIV/AIDS in 2006, 2007, and 2008 was heterosexual transmission. The participants completed a confidential questionnaire on 2 occasions separated by 3 months via audio computer-assisted self-interview. We examined consistent condom use with separate questions regarding condom use with steady partners and casual partners. The outcome in the analyses combines consistent condom use with both types of partners.
Results / Comments: The participants were 202 men (mean age = 39.8 years); 23.4% had less than a high school education; 65.2% were unemployed. About 19.8% reported consistent condom use during vaginal intercourse in the previous 3 months, and 54.2% reported having vaginal intercourse with multiple partners in the previous 3 months. About 25.9% reported being sexually abused before age 16 years, and 5.5% reported having HIV. Of the 202 participants, 183 or 90.6% completed the 3-month follow-up ACASI. To examine whether the theory of planned behavior accounted for condom-use intention, baseline condom-use intention was regressed on baseline attitude, subjective norm, and self-efficacy regarding condom use. The regression coefficients indicated that men who expressed more favorable attitude (P = 0.008), greater subjective norm (P < 0.0001), and greater self-efficacy (P < 0.0001) reported a firmer intention to use condoms than did other men. At the 3-month follow-up, 21.5% of the men reported using condoms consistently in the previous 3 months. Consistent condom use reported at 3-month follow-up was regressed on baseline condom-use intention. The regression coefficient was statistically significant (P = 0.008), indicating that the intention to use condoms predicted consistent condom use 3 months later. These findings were similar to those obtained in separate analyses on condom use with steady as opposed to casual partners.
Discussion: In conclusion, the results of this prospective study revealed that, in accord with the theory of planned behavior, attitude, subjective norm, and self-efficacy are important determinants of the condom-use intention among heterosexually active African American men and condom-use intention predicts subsequent condom use. The study demonstrated that many African American men fail to use condoms consistently with their female partners. The prospective intention-behavior link held irrespective of whether the partners were steady or casual. However, as far as we know, this is the first prospective study linking intention to condom use in African American men who have sex with women.
Go Back