The influence of perceived behaviour control, attitude and empowerment on reported condom use and intention to use condoms among adolescents in rural Tanzania
Open Access
- 13 November 2015
- journal article
- research article
- Published by Springer Science and Business Media LLC in Reproductive Health
- Vol. 12 (1), 1-9
- https://doi.org/10.1186/s12978-015-0097-5
Abstract
Despite the declining trends of Human immunodeficiency virus (HIV) infection in Sub-Saharan Africa (SSA), unsafe sexual behaviours among adolescents still represent a public health challenge. It is important to understand factors acting at different levels to influence sexual behaviour among adolescents. This study examined the influence of perceived behaviour control, subjective norms, attitudes and empowerment on intention to use condoms and reported use of condoms among adolescents in rural Tanzania. We used a questionnaire to collect data from 403 adolescents aged 14 through 19 years from nine randomly selected secondary schools in the Newala district located in the Southern part of Tanzania. The self-administered questionnaire collected information on sexual practices and factors such as attitudes, subjective norms, perceived behaviour control and empowerment. Binary logistic regression was performed to identify factors associated with intention to use and reported use of condoms. Sexually active adolescents constituted 40.6 % of the sample, among them 49.7 % did not use a condom at last sexual intercourse and 49.8 % had multiple sex partners. Many (85 %) of sexually active respondents had their sexual debut between the ages of 14 to 17 years. Girls became sexually active earlier than boys. Perceived behaviour control predicted intentions to use condoms (AOR = 3.059, 95 % CI 1.324-7.065), thus demonstrating its importance in the decision to use a condom. Empowerment (odds ratio = 3.694, 95 % CI 1.295-10.535) and a positive attitude (AOR = 3.484, 95 % CI 1.132-10.72) predicted reported condom use, thus turning the decision to actions. Subjective norms had only indirect effects on intention and reported use of condoms. The findings suggest that unsafe sex practices are prevalent among school adolescents in rural areas of Tanzania. Perceived behaviour control and positive attitudes predict intensions to use condoms whereas empowerment predicts reported condom use. The findings may imply that safe sex promotion interventions that simultaneously address socio-cognitive and ecological determinants of sexual behaviours may improve adolescents’ safe sex behaviours.Keywords
This publication has 43 references indexed in Scilit:
- High Risk Sexual Behaviors for HIV among the In-School Youth in Swaziland: A Structural Equation Modeling ApproachPLOS ONE, 2013
- Multiple sexual partners and condom use among 10 - 19 year-olds in four districts in Tanzania: What do we learn?BMC Public Health, 2011
- Applying ecological perspectives to adolescent sexual health in the United States: rhetoric or reality?Health Education Research, 2009
- Sexual practices among unmarried adolescents in TanzaniaBMC Public Health, 2009
- Correlates of intention to use condoms among Sub-Saharan African youth: The applicability of the theory of planned behaviourScandinavian Journal of Public Health, 2009
- Prevalence And Correlates Of Condom Use At Last Sexual Intercourse Among Inschool Adolescents In Urban Areas Of UgandaEast African Journal of Public Health, 2008
- Predictors of early sexual initiation among a nationally representative sample of Nigerian adolescentsBMC Public Health, 2008
- Predictors of Condom Use Among Young Adults in South Africa: The Reproductive Health and HIV Research Unit National Youth SurveyAmerican Journal of Public Health, 2007
- The theory of planned behaviorOrganizational Behavior and Human Decision Processes, 1991
- An Ecological Perspective on Health Promotion ProgramsHealth Education Quarterly, 1988