Determinants of Consistent Condom Use among College Students in China: Application of the Information-Motivation-Behavior Skills (IMB) Model

Abstract

BackgroundDue to the increase incidents of premarital sex and the lack of reproductive health services, college students are at high risk of HIV/AIDS infections in China. This study was designed to examine the predictors of consistency of condom use among college students based on the Information-Motivation-Behavioral Skills (IMB) model and to describe the relationships between the model constructs.MethodsA cross-sectional study was conducted to assess HIV/AIDS related information, motivation, behavioral skills and preventive behavior among college students in five colleges and universities in Nanjing, China. An anonymous questionnaire survey was conducted for data collection, and the structural equation model (SEM) was used to assess the IMB model.ResultsA total of 3183 participants completed this study. The average age was 19.90 years (SD = 1.43, range 16 to 25). 342 (10.7%) participants of them reported having had premarital sex, among whom 30.7% reported having had a consistent condom use, 13.7% with the experience of abortion (including the participants whose sex partner has the same experience), 32.7% of participants had experience of multiple sex partners. The final IMB model provided acceptable fit to the data (CFI = 0.992, RMSEA = 0.028). Preventive behavior was significantly predicted by behavioral skills (β = 0.754, P<0.001). Information (β = 0.138, P<0.001) and motivation (β = 0.363, P<0.001) were indirectly affected preventive behavior, and was mediated through behavioral skills.ConclusionsThe results of the study demonstrate the utility of the IMB model for consistent condom use among college students in China. The main influencing factor of preventive behavior among college students is behavioral skills. Both information and motivation could affect preventive behavior through behavioral skills. Further research could develop preventive interventions based on the IMB model to promote consistent condom use among college students in China.

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

“…Specifically, past studies found that information does not always have a direct effect on sexual risk behavior, but many studies suggest that information remains a necessary component of HIV prevention interventions because of the influence knowledge has on behavioral skills. Our results fit with other studies that found that information significantly predicted behavioral skills, but did not directly predict sexual risk behavior [21–22,24,32,44,48–49,54]; however, our results conflict with those that found no effect of information [25–28,31,35] and those with a direct relationship with condom use [22,43]. It has been argued that the importance of HIV prevention information may be attenuated within populations with higher levels of knowledge [37], and we found low levels of HIV prevention knowledge within this sample of alcohol-using STI clinic patients providing additional evidence in support of this hypothesis.…”

“…Our results suggest motivation had a direct effect on behavioral skills, but also had a direct effect on sexual risk behavior. This partial mediation effect of motivation on sexual risk behavior through behavioral skills is consistent with other IMB model research [21,25,27–29,31,35,44,54], but conflicts with evidence of a fully-mediating effect [32,36,43,49]. Thus, motivation and behavioral skills remain important components of the IMB model, but some populations may rely more heavily upon behavioral skills to enact protective behavior compared to others.…”

“…Gender-specific situational questions were used, and an example question is “how confident are you that you could bring up the issue of condoms or safe sex in a conversation in this situation?” [42]. Self-efficacy has been frequently used as a proxy for behavioral skills within the IMB model literature [22–25,27–28,30,32,35–36,43–49]. …”

Information-Motivation-Behavioral Skills model of consistent condom use among transgender women in Shenyang, China

“…Theory-based intervention is widely believed to be more likely to effectively change behavior and maintain such behavior change than non-theory-based intervention. Among extant theory and models, the Information-Motivation-Behavioral Skills (IMB) model has received consistent empirical support in the context of HIV prevention among various key populations, including heterosexual people living with HIV [15], sexually transmitted infection (STI) clinic patients [16], female sex workers [17], senior high school students [18,19], college students [20], male street laborers [21], unmarried female migrants [22], and MSM [23].…”

Información, motivación y habilidades conductuales asociadas al uso del condón en la última relación sexual en hombres privados de la libertad

“…Desde el modelo IMB, se ha encontrado que es más probable que se protejan y usen el preservativo los hombres con información de cómo protegerse, motivados para usar condón y con las habilidades para hacerlo (Bermúdez, Herencia Leva y Uribe, 2009;Cunill, Gras, Planes y Serda, 2012;Espada, Morales, Guillén, Ballester y Orgilés, 2016;Liu, et al, 2014;Mazo, Domínguez y Cardona, 2014;Uribe, Aguilar, Zacarías y Aguilar, 2015).…”