Factors associated with self-efficacy for condom use and sexual negotiation among South african youth

Jennifer N Sayles, Audrey Pettifor, Mitchell D Wong, Catherine MacPhail, Sung-Jae Lee, Ellen Hendriksen, Helen V Rees, Thomas Coates, Jennifer N Sayles, Audrey Pettifor, Mitchell D Wong, Catherine MacPhail, Sung-Jae Lee, Ellen Hendriksen, Helen V Rees, Thomas Coates

Abstract

Objectives: To use logistic regression modeling to identify factors associated with high self-efficacy for sexual negotiation and condom use in a sample of South African youth.

Methods: The Reproductive Health and HIV Research Unit (RHRU) National Youth Survey examined a nationally representative sample of 7409 sexually active South African youth aged 15 to 24 years. We used logistic regression modeling in this sample to identify factors associated with the main outcome of high self-efficacy.

Results: Among female respondents (n = 3890), factors associated with high self-efficacy in the adjusted model were knowing how to avoid HIV (odds ratio [OR] = 2.30, 95% confidence interval [CI]: 1.05 to 5.00), having spoken with someone other than a parent or guardian about HIV/AIDS (OR = 1.46, 95% CI: 1.01 to 2.10), and having life goals (OR = 1.28, 95% CI: 1.10 to 1.48). Not using condoms during their first sexual encounter (OR = 0.61, 95% CI: 0.50 to 0.76), a history of unwanted sex (OR = 0.66, 95% CI: 0.51 to 0.86), and believing that condom use implies distrust in one's partner (OR = 0.57, 95% CI: 0.51 to 0.86) were factors associated with low self-efficacy among female respondents. Male respondents (n = 3519) with high self-efficacy were more likely to take HIV seriously (OR = 4.03, 95% CI: 1.55 to 10.52), to believe they are not at risk for HIV (OR = 1.38, 95% CI: 1.12 to 1.70), to report that getting condoms is easy (OR = 1.85, 95% CI: 1.23 to 2.77), and to have life goals (OR = 1.30, 95% CI: 1.10 to 1.54). Not using condoms during their first sexual experience (OR = 0.51, 95% CI: 0.39 to 0.67), a history of having unwanted sex (OR = 0.47, 95% CI: 0.34 to 0.64), believing condom use is a sign of not trusting one's partner (OR = 0.63, 95% CI: 0.46 to 0.87), and refusing to be friends with HIV-infected persons (OR = 0.52, 95% CI: 0.32 to 0.85) were factors associated with low self-efficacy among male respondents in the fully adjusted model.

Conclusions: We used the social cognitive model (SCM) to identify factors associated with self-efficacy for condom use and sexual negotiation. Many of these factors are modifiable and suggest potential ways to improve self-efficacy and reduce HIV sexual risk behavior in South African youth.

Figures

FIGURE 1
FIGURE 1
Paths of influence in the SCM. Beliefs of personal efficacy for condom use and sexual negotiation affect the behavior of condom use directly by their impact on goals, outcome expectations, and perceived facilitators and impediments. Knowledge about HIV infection as well as sociodemographic characteristics and prior sexual experiences also may influence self-efficacy for condom use (Adapted from Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31:145; with permission.)

References

    1. Pettifor AE, Rees HV, Kleinschmidt I, et al. Young people’s sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. AIDS. 2005;19:1525–1534.
    1. South African National HIV Prevalence, Behavioural Risks and Mass Media: Household Survey 2002: Executive Summary. Human Sciences Research Council; Cape Town, South Africa: 2002. Nelson Mandela/HSRC Study of HIV/AIDS.
    1. South African National HIV Prevalence, Behavioural Risks and Mass Media: Household Survey 2005: Executive Summary. Human Sciences Research Council; Cape Town, South Africa: 2005. Nelson Mandela/HSRC Study of HIV/AIDS.
    1. Hendriksen ES, Lee SJ, Coates TJ, et al. Ther RHRU National Youth Survey Predictors of condom use among South African youth age 15-24. Am J Public Health. in press.
    1. Warren M. Condom use in South Africa: facts and fantasies. Natl AIDS Bull. 1997;1:4–6.
    1. Shelton JD, Johnston B. Condom gap in Africa: evidence from donor agencies and key informants. BMJ. 2001;323:139.
    1. James S, Reddy SP, Taylor M, et al. Young people, HIV/AIDS/STIs and sexuality in South Africa: the gap between awareness and behaviour. Acta Paediatr. 2004;93:264–269.
    1. Baele J, Dusseldorp E, Maes S. Condom use self-efficacy: effect on intended and actual condom use in adolescents. J Adolesc Health. 2001;28:421–431.
    1. Mashegoane S, Moalusi KP, Peltzer K, et al. The prediction of condom use intention among South African university students. Psychol Rep. 2004;95:407–417.
    1. Giles M, Liddell C, Bydawell M. Condom use in African adolescents: the role of individual and group factors. AIDS Care. 2005;17:729–739.
    1. Fischer JD, Fisher AW. Changing AIDS risk behaviour. Psychol Bull. 1992;111:455–474.
    1. Catania JA, Kegeles SM, Coates TJ. Towards an understanding of risk behaviour: an AIDS risk reduction model (ARRM) Health Educ Q. 1990;17:53–72.
    1. Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31:143–164.
    1. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215.
    1. Hanna K. An adolescent and young adult condom self-efficacy scale. J Pediatr Nurs. 1999;14:59–66.
    1. Pettifor AE. Sexual power and HIV risk, South Africa. Emerg Infect Dis. 2004;10:1996–2004.
    1. Pulerwitz J, Gortmaker SL, De Jong W. Measuring sexual relationship power in HIV/STD research. Sex Roles. 2000;42:637–650.
    1. Pulerwitz J, Amaro H, De Jong W, et al. Relationship power, condom use and HIV risk among women in the USA. AIDS Care. 2002;14:789–800.
    1. Ingham R, Woodcock A, Stenner K. The Limitations of Rational Decision-Making Models as Applied to Young People’s Sexual Behaviour. Falmer Press; London, UK: 2001.
    1. Joffe H. AIDS research and prevention: a social representational approach. Br J Med Psychol. 1996;69:169–190.
    1. MacPhail C. Adolescents and HIV in developing countries: new research directions. Psychology in Society. 1998;24:69–87.
    1. Campbell C, MacPhail C. Peer education, gender and the development of critical consciousness: participatory HIV prevention by South African youth. Soc Sci Med. 2002;55:331–345.
    1. Campbell C, Jovchelovitch S. Health, community and development: towards a social psychology of participation. Journal of Applied and Community Social Psychology. 2000;10:255–270.
    1. Campbell C, Williams B. Evaluating HIV prevention programmes: conceptual challenges. Psychology in Society. 1998;24:57–68.
    1. MacPhail C, Campbell C. ‘I think condoms are good but, aai, I hate those things’: condom use among adolescents and young people in a Southern African township. Soc Sci Med. 2001;52:1613–1627.
    1. Holland J, Ramazanoglu C, Scott S, et al. Between embarrassment and trust: young women and the diversity of condom use. In: Aggelton PDP, Hart G, editors. AIDS: Responses, Interventions and Care. Falmer Press; London, UK: 1991. pp. 127–148.
    1. Hoffman SOL, Harrison A, Dolezal C, et al. HIV risk behaviours and the context of sexual coercion in young adults’ sexual interactions: results from a diary study in rural South Africa. Sex Transm Dis. 2006;33:52–58.
    1. Meyer-Weitz A, Reddy P, Weijts W, et al. The socio-cultural contexts of sexually transmitted diseases in South Africa: implications for health education programmes. AIDS Care. 1998;10(Suppl 1):S39–S55.
    1. Leibowitz S, Castellano DC, Cuellar I. Factors that predict sexual behaviors among young Mexican American adolescents: an exploratory study. Hisp J Behav Sci. 1999;24:470–479.
    1. Villarruel AM, Jemmott JB, III, Jemmott LS, et al. Predictors of sexual intercourse and condom use intentions among Spanish-dominant Latino youth: a test of the planned behavior theory. Nurs Res. 2004;53:172–181.
    1. Salazar LF, DiClemente RJ, Wingood GM, et al. Self-concept and adolescents’ refusal of unprotected sex: a test of mediating mechanisms among African American girls. Prev Sci. 2004;5:137–149.
    1. Aggleton P, Campbell C. Working with young people—towards an agenda of sexual health. Sex Relationship Ther. 2000;15:283–296.
    1. Hiller L, Harrison L, Warr D. When you carry condoms all the boys think that you want it: negotiating competing discourses about safe sex. J Adolesc. 1998;21:15–19.
    1. Lear D. Sexual communication in the age of AIDS: the construction of risk and trust among young adults. Soc Sci Med. 1995;41:1311–1323.
    1. Dunkle KL, Jewkes RK, Brown HC, et al. Gender-based violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa. Lancet. 2004;363:1415–1421.
    1. Varga C. How gender roles influence sexual and reproductive health among South African adolescents. Stud Fam Plann. 2003;34:160–172.

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