Safer sex intentions and condom use viewed from a health belief, reasoned action, and social cognitive perspective

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Abstract
We conducted three studies and used structural equation modeling to examine how well the health belief model, the theory of reasoned action, and social cognitive theory are capable of explaining heterosexual persons’ sexual risk taking. Study 1 was conducted with sexually active young adults (college students) who completed an anonymous questionnaire about their sexual behavior and concepts pertaining to the three models. The analyses identified conceptually analogous concepts in the three models that explained a significant part of the variance in intentions to practice safer sex. These concepts referred to cognitive‐affective reactions toward condom use and the social context of using condoms. A concept unique to social cognitive theory, self‐efficacy, explained additional variance. In Study 2, these findings were replicated with sexually active older adults (members of a singles network). In both studies, the model based on social cognitive theory explained more than 70% of the variance in intentions to use condoms. In Study 3, this model was then tested longitudinally over a three‐month interval with sexually active college students. It explained 50% of the variance in condom use. Together, the studies suggest that condom use in heterosexual relations depends to a significant degree on three key factors: the expected consequences of condom use, perceived social support for using condoms, and self‐efficacy.