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The purpose of this meta-review was to identify characteristics of successful HIV prevention interventions for adolescents based on quantitative (i.e., meta-analyses) and qualitative reviews published to date, and to inform intervention utilization and future development. To that end, we were guided by principles of triangulation. Searches of seven electronic bibliographic databases yielded five meta-analyses and six qualitative reviews that satisfied the selection criteria. Reviews were subjected to careful content analysis. All reviews reported that behavioral interventions had positive outcomes on at least one of the following outcomes: HIV-related knowledge, subjective cognitions and beliefs enabling safer sex, abstinence, delaying next sexual intercourse, decreasing number of sexual partners, and actual condom use. Four categories, suggesting factors more prominently linked to intervention success, emerged: behavior change techniques (e.g., cognitive-behavior and motivation enhancement skills training); recipient characteristics (e.g., age, vulnerability to contracting STIs/HIV); prominent design features (e.g., use of theory, formative research); and socio-ecological features (e.g., supportive school environment). Future interventions would benefit from conducting preliminary formative research in order to enable optimal implementation of all these factors.

Amongst the psychological theories that have been used to help understand why people have unprotected sex, the Theory of Planned Behaviour (TPB: Ajzen 1991) has earned a prominent position. This article is a critical review of 11 peer-reviewed studies conducted in sub-Saharan Africa during 2001 to 2009, which used the TPB as a model of predicting sexual risk behaviour in young people. All the studies revealed the predictive ability of the TPB in urban, rural, and traditional African settings, with R (2) coefficients ranging between 0.14 and 0.67. With data comparing favourably to those obtained in the international literature, these studies indicate that the TPB can be used to study sexual risk intentions and behaviour in sub-Saharan African youth, and question arguments against the theory's use in non-Western settings.

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Findings provide preliminary evidence to support the integrated condom use model in sub-Saharan African youth. The model provides guidance on potential targets for improving the effectiveness of condom promotion interventions. (PsycINFO Database Record

This study was carried out among university undergraduates in Cape Town, South Africa. Structural equation models were tested with Mplus to predict intentions to use condoms and actual (subsequent) condom use. Theory of planned behavior (TPB) predictors (attitudes, subjective norms, perceived behavioral control) explained 43% of the variance of intention to use condoms among the sexually active sample, and 31% among the sexually inactive. In a separate analysis-which also included intentions and previous condom use as predictors-57% of subsequent condom use among the sexually active students was explained. Moreover, age, religiosity, and relationship status were associated with condom use. Our findings provide support for the applicability and suitability of the TPB in South African student populations.

Objective: We tested an integrated social cognitive model derived from multiple theories of the determinants of young peoples’ condom use in Sub-Saharan Africa. The model comprised seven social cognitive antecedents of condom use: Attitudes, norms, control, risk perceptions, barriers, intentions, and previous condom use. Methods: We conducted a systematic search of studies including effects between at least one model construct and intended or actual condom use in young people from sub-Saharan African countries. Fifty-five studies comprising 72 independent data sets were included and subjected to random-effects meta-analysis. Demographic and methodological variables were coded as moderators. Hypotheses of the integrated model were tested using meta-analytic structural equation modeling. Results: The meta-analysis revealed significant non-trivial sample-weighted correlations among most model constructs. Moderator analyses revealed differences in six correlations for studies that included a formative research component relative to studies that did not. There was little evidence of systematic moderation of relations among model constructs by other candidate moderators. Meta-analytic structural equation models revealed significant direct effects of attitudes, norms, and control on condom use intentions, and of intention, control, and barriers on condom use. Including past condom use increased explained variance in condom use intentions and behavior but did not attenuate model effects. There were also significant indirect effects of attitudes, norms, and control on condom use through intentions. Conclusions: Findings provide preliminary evidence to support the integrated condom use model in sub-Saharan African youth. The model provides guidance on potential targets for improving the effectiveness of condom promotion interventions.

Our data revealed the value of considering the combined effects of relationship status, habit and attitudes, when investigating undergraduate non-condom use intentions and designing interventions. The construct of TP was introduced as a meaningful addition to sexual risk research.