Condom use among South African adolescents: Developing and testing theoretical models of intentions and behavior

We developed and tested models of intentions and behavior among adolescents from Cape Town, South Africa. Data from 261 participants who completed an initial measure of attitudes, beliefs, and prior behavior were used to develop a model of intentions to use condoms based on the Theory of Planned Behavior (TPB) and additional constructs found to be important in previous research with adolescents. Of the initial sample, 227 (87%) completed a behavioral follow-up 4 months later, and approximately one-third of those (n=72; 44 boys and 30 girls) reported having had sex in the prior 4 months. Data from this smaller sample were used to develop a model of condom use behavior based on intentions (as per the TPB) and the additional sub-population relevant constructs. Analyses generally supported the validity of the TPB in this context for predicting intentions and behavior. HIV knowledge and positive outlook (self-esteem and future optimism) were significantly related to TPB predictors of intentions. Intentions, acceptance of sexuality, and gender were significant predictors of behavior. Implications for the status of the TPB and the design of interventions for South African adolescents are discussed.