Sexual Protection Behavior in HIV-Positive Gay Men: Testing a Modified Information-Motivation-Behavioral Skills Model

Abstract

This study on determinants of sexual protection behavior among HIV-positive gay men used the empirically tested information-motivation-behavioral skills (IMB) model. HIV-specific variables were added to the model to determine factors decisive for condom use with steady and casual partners. Data were collected using an anonymous, standardized self-administered questionnaire. Study participants were recruited at HIV outpatient clinics associated with the Eurosupport Study Group and the Swiss HIV Cohort Study. To identify factors associated with condom use, backward elimination regression analyses were performed. Overall, 838 HIV-infected gay men from 14 European countries were included in this analysis. About 53% of them reported at least one sexual contact with a steady partner; 62.5% had sex with a casual partner during the last 6 months. Forty-three percent always used condoms with steady partners and 44% with casual partners. High self-efficacy and subjective norms in favor of condom-use were associated with increased condom use with casual and steady partners, whereas feeling depressed was associated with decreased condom use with casual partners. Condoms were used less often with HIV-positive partners. Self-efficacy as an important behavioral skill to perform protection behavior was influenced by lower perceived vulnerability, higher subjective norms, and more positive safer sex attitudes. The IMB-model constructs appeared to be valid; however, not all the model predictors could be determined as hypothesized. Besides the original IMB constructs, HIV-specific variables, including sexual partners' serostatus and mental health, explained condom use. Such factors should be considered in clinical interventions to promote "positive prevention."

Tuberculosis infection control in a high drug-resistance setting in rural South Africa: Information, motivation, and behavioral skills

“…Trimming or modifying our TB IC IMB models by removing the information inputs resulted in a more accurate characterization of implementation. This finding is in line with some IMB studies that found that information was not strongly predictive of regular safer sexual practices among various populations [13][14][15]33]. A possible reason for the inconsistent associations of information in our study is that the generally high information levels of our sample may have caused a ceiling effect (i.e., knowledge was high enough to no longer have a measurable effect on implementation frequency).…”

“…1) states that well-informed, motivated individuals develop necessary behavioral skills, which lead to effective practices [12]. This model has been useful in characterizing and enhancing HIV risk reduction behaviors [13][14][15], antiretroviral therapy adherence [16][17][18], and diet and exercise [19]. We hypothesized that the IMB model could characterize HCW TB IC adherence and inform IC enhancement.…”

Psychosocial Factors and HIV Prevention for Gay, Bisexual, and Other Men Who Have Sex with Men

“…However, HIV‐related information was not a significant predictor of CAS. Other researchers also have failed to find a significant relation between HIV knowledge and CAS (e.g., Newcomb & Mustanski, ; Nostlinger et al, ). It is likely, though, that HIV‐related knowledge has an effect on sexual behaviors through impacting behavioral skills (e.g., discussing safer sex with partners) instead of solely a direct effect (Fisher, Fisher, Williams, & Malloy, ).…”

Cultural Adaptation of an Intervention to Reduce Sexual Risk Behaviors among Patients Attending a STI Clinic in St. Petersburg, Russia

“…The intervention, originally developed in the U.S., was chosen for adaptation for use in Russia for two reasons. First, it is based on the Information-Motivation-Behavioral Skills (IMB) model (Fisher JD & Fisher WA, 1992, 2000), a well-validated theoretical model for predicting health promotion behaviors (including HIV prevention behaviors) and has been used to develop effective behavioral interventions for use throughout the world (Ali SS & Manongi RR, 2010; Amico KR et al , 2009; Ferrer RA et al , 2010; Malow RM et al , 2009; Nostlinger C et al , 2011; Osborn CY et al , 2010c; Osborn CY & Egede LE, 2010a; Osborn CY et al , 2010b; Peltzer KK et al , 2011; Shattuck D et al , 2011; Tipwareerom W et al , 2011; Zhang H et al , 2011); hence, it has proven applicability across many populations and cultures. The IMB model states that HIV information (i.e., knowledge about transmission, risk, and prevention), motivation to engage in HIV preventive behaviors, and behavioral skills are necessary prerequisites to engaging in such behaviors.…”