The Information-Motivation-Behavioral Skills Model Revisited: A Network-Perspective Structural Equation Model Within a Public Sexually Transmitted Infection Clinic Sample of Hazardous Alcohol Users

Steven A John, Jennifer L Walsh, Lance S Weinhardt, Steven A John, Jennifer L Walsh, Lance S Weinhardt

Abstract

The information-motivation-behavioral skills (IMB) model is useful for understanding sexual risk behavior, but has not been tested with hazardously-drinking sexually transmitted infection (STI) clinic patients, a subpopulation at greater HIV risk, or with a network-perspective sexual risk behavior outcome. Participants (N = 569) were STI clinic patients who screened positive for hazardous drinking and risky sexual behavior. Sexual risk behavior (SRB) was operationalized as a latent variable with three indicators: (1) number of sexual partners, (2) number of unprotected sex occasions with primary partner, and (3) number of unprotected sex occasions with non-primary partner(s). Preliminary analyses suggested SRB was best operationalized as a latent variable with two indicators, while unprotected sex with primary partners should be considered separately. In structural models with good fit, the IMB model was generally supported. The IMB model functioned differently for non-primary and multiple partners compared to primary partners in STI clinic patients with hazardous alcohol use.

Keywords: Behavioral theory; HIV/AIDS; Hazardous alcohol users; IMB model; Sexual risk behavior.

Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Information–motivation–behavioral skills conceptual model. Note information–motivation–behavioral skills model adapted from Fisher et al. [56]
Fig. 2
Fig. 2
Preliminary model path diagram completely standardized of the information–motivation–behavioral skills model predicting general sexual risk behavior among STI clinic patients with hazardous alcohol use (N = 569). Notes * p < 0.05; all disturbance terms were significant (p < 0.05), but removed for interpretation ease; this model had adequate but less than ideal fit [χ2(16) = 80.98, p < 0.01; RMSEA = 0.085 (0.067–0.103 90 % CI); NNFI = 0.852; CFI = 0.915]
Fig. 3
Fig. 3
Path diagram completely standardized of the information–motivation–behavioral skills model predicting sexual risk behavior with outside partners among STI clinic patients with hazardous alcohol use (N = 569). Notes * p < 0.05; all disturbance terms were significant (p < 0.05), but removed for interpretation ease; this model had acceptable fit [χ2(10) = 21.42, p = 0.02, χ2/df ratio = 2.14; RMSEA = 0.045 (0.018–0.071 90 % CI); NNFI = 0.963; CFI = 0.982]
Fig. 4
Fig. 4
Path diagram completely standardized of the information–motivation–behavioral skills model predicting sexual risk behavior with primary partners among STI clinic patients with hazardous alcohol use (N = 569). Notes * p < 0.05; a single indicator with no error adjustment; all disturbance terms were significant (p < 0.05), but removed for interpretation ease; this model had acceptable fit [χ2(6) = 12.50, p = 0.05, χ2/df ratio = 2.08; RMSEA = 0.044 (0.000–0.078 90 % CI); NNFI = 0.957; CFI = 0.983]

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