期刊论文详细信息
BMC Public Health
Correlates of delayed sexual intercourse and condom use among adolescents in Uganda: a cross-sectional study
Gerjo Kok5  Joanne N Leerlooijer2  Robert AC Ruiter5  Rico Lie1  Arjan ER Bos3  Liesbeth E Rijsdijk4 
[1]Wageningen University, Wageningen, the Netherlands
[2]RutgersWPF, Utrecht, the Netherlands
[3]Open University, Heerlen, the Netherlands
[4]Windesheim University of Applied Sciences, Windesheim Honours College, Zwolle, the Netherlands
[5]Maastricht University, Maastricht, the Netherlands
关键词: sub-Saharan Africa;    Segmented approach;    Self-efficacy;    Social norms;    Attitudes;    Condom use;    Delayed sexual intercourse;    Ugandan adolescents;   
Others  :  1163046
DOI  :  10.1186/1471-2458-12-817
 received in 2012-02-07, accepted in 2012-09-12,  发布年份 2012
PDF
【 摘 要 】

Background

Comprehensive sex education, including the promotion of consistent condom use, is still an important intervention strategy in tackling unplanned pregnancies, HIV/AIDS and sexually transmitted infections (STIs) among Ugandan adolescents. This study examines predictors of the intention to use a condom and the intention to delay sexual intercourse among secondary school students (aged 12–20) in Uganda.

Methods

A school-based sample was drawn from 48 secondary schools throughout Uganda. Participants (N = 1978) completed a survey in English measuring beliefs regarding pregnancy, STIs and HIV and AIDS, attitudes, social norms and self-efficacy towards condom use and abstinence/delay, intention to use a condom and intention to delay sexual intercourse. As secondary sexual abstinence is one of the recommended ways for preventing HIV, STIs and unplanned pregnancies among the sexually experienced, participants with and without previous sexual experience were compared.

Results

For adolescents without sexual experience (virgins), self-efficacy, perceived social norms and attitude towards condom use predicted the intention to use condoms. Among those with sexual experience (non-virgins), only perceived social norm was a significant predictor. The intention to delay sexual intercourse was, however, predicted similarly for both groups, with attitudes, perceived social norm and self-efficacy being significant predictors.

Conclusions

This study has established relevant predictors of intentions of safe sex among young Ugandans and has shown that the intention to use condoms is motivated by different factors depending on previous sexual experience. A segmented approach to intervention development and implementation is thus recommended.

【 授权许可】

   
2012 Rijsdijk et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150413090154585.pdf 225KB PDF download
【 参考文献 】
  • [1]Wabwire-Mangen F, Odiit M, Kirungi W, Kisitu DK, Wanyama JO: Uganda HIV modes of transmission and prevention response analysis. Final Report. Kampala: Uganda National AIDS Commission; 2009. Available at: http://siteresources.worldbank.org/INTHIVAIDS/Resources/375798-1103037153392/UgandaMoTCountrySynthesisReport7April09.pdf webcite
  • [2]UNAIDS: Report on the Global AIDS epidemic. Geneva, Switzerland; 2004. Available at: http://data.unaids.org/Global-Reports/Bangkok 2004/unaidsbangkokpress/gar2004html/gar2004_00_en.htm webcite
  • [3]UNAIDS: Global report. UNAIDS report on the global AIDS epidemic 2010. Geneva, Switzerland; 2010. Available at: http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf webcite
  • [4]Opio A, Mishra V, Hong R, Musinguzi J, Kirungi W, Cross A, Mermin J, Bunnell R: Trends in HIV-related behaviours and knowledge in Uganda, 1989–2005: Evidence of a shift toward more risk-taking behaviours. J Acquir Immune Defic Syndr 2008, 9(3):320-326.
  • [5]Uganda Bureau of Statistics (UBOS) and Macro International Inc: Uganda Demographic and Health Survey 2006. 2007.
  • [6]Tumwesigye NM, Ingham R, Holmes D: The dynamics of secondary abstinence among unmarried young people: Analysis of event history calendar data from Kabale and Mukono in Uganda. The African Statistical Journal 2008, 6:67-86.
  • [7]Khan S, Mishra V: Youth Reproductive and Sexual Health. DHS Comparative Reports No. 19. Macro International Inc. Calverton, Maryland; 2008. Retrieved from: http://pdf.usaid.gov/pdf_docs/PNADM644.pdf webcite
  • [8]Biddlecom AE, Hessburg L, Singh S, Bankole A, Darabi L: Protecting the next generation in Sub-Saharan Africa: Learning from Adolescents to prevent HIV and Unintended Pregnancy. New York: Guttmacher Institute; 2007. Retrieved from: http://www.guttmacher.org/pubs/2007/12/12/PNG_monograph.pdf webcite
  • [9]Government of Uganda: Uganda UNGASS Progress Report, Jan 2008-Dec 2009. Kampala; 2010. Retrieved from: http://www.unaids.org/en/dataanalysis/monitoringcountryprogress/2010progressreportssubmittedbycountries/uganda_2010_country_progress_report_en.pdf webcite
  • [10]Kok G, Schaalma HP, Ruiter R, van Empelen P, Brug J: Intervention Mapping: A protocol for applying health psychology theory to prevention programmes. J Health Psychol 2004, 9:85-98.
  • [11]Schaalma HP, Aarø LE, Flisher AJ, Mathews C, Kaaya S, Onya H, Ragnarson A, Klepp KI: Correlates of intention to use condoms among sub-Saharan African youth: The applicability of the theory of planned behaviour. Scand J Public Health 2009, 37(Suppl 2):87-91.
  • [12]Bartholomew LK, Parcel GS, Kok G, Gottlieb N, Fernandez ME: Planning Health promotion Programs. An Intervention Mapping Approach. 3rd edition. San Francisco: JosseyBass; 2011.
  • [13]Ajzen I: The Theory of Planned Behavior. Organizational Behaviour &Human Decision Processes 1991, 50:179-211.
  • [14]Ajzen I: Perceived behavioral control, self-efficacy, locus of control, and the theory of planned behavior. J Appl Soc Psychol 2002, 32(4):665-683.
  • [15]Fishbein M, Ajzen I: Predicting and changing Behavior. The Reasoned Action Approach. New York (NY): Psychology Press, Taylor and Francis Group; 2010.
  • [16]Webb TL, Sheeran P: Does changing behavioural intentions engender behaviour change? A meta-analysis of the experimental evidence. Psychol Bull 2006, 132(2):249-268.
  • [17]Fishbein M: Changing behavior to prevent STDs/AIDS. Int J Gynecol Obstet 1998, 63(Suppl 1):175-181.
  • [18]Godin G, Kok G: The theory of planned behavior: A review of its applications to health-related behaviors. The Science of Health Promotion 1996, 11:87-98.
  • [19]Armitage CJ, Conner M: Efficacy of the theory of planned behaviour: A meta-analytic review. Br J Soc Psychol 2001, 40:471-499.
  • [20]Sheeran P, Abraham C, Orbell S: Psychosocial correlates of heterosexual condom use: A meta-analysis. Psychol Bull 1999, 125(1):90-132.
  • [21]Bennet P, Bozionelos G: The theory of planned behaviour as predictor of condom use: a narrative review. Psychol Health Med 2000, 5(3):307-326.
  • [22]Albarracı´n D, Johnson BT, Fishbein M, Muellerleile PA: Theories of reasoned action and planned behavior as models of condom use: A meta-analysis. Psychol Bull 2001, 127(1):142-161.
  • [23]Schaalma HP, Kok G, Peters L: Determinants of consistent condom use by adolescents: The impact of experience of sexual intercourse. Health Educ Res 1993, 8:255-269.
  • [24]Jemmott JB, Jemmott LS: HIV risk reduction behavioral interventions with heterosexual adolescents. AIDS 2000, 14(Suppl 2):S40-S52.
  • [25]Aarø LE, Flisher AJ, Kaaya S, Onya H, Fuglesang M, Klepp KI, Schaalma HP: Promoting sexual and reproductive health in early adolescence in South Africa and Tanzania: Development of a theory- and evidence based intervention programme. Scand J Public Health 2006, 34(2):150-158.
  • [26]Gredig D, Nideroest S, Parpan-Blaser A: HIV-protection through condom use: Testing the theory of planned behaviour in a community sample of heterosexual men in a high-income country. Psychol Health 2006, 21(5):541-555.
  • [27]Carjaval SC, Parcel GS, Banspach SW, Basen-Engquist K, Coyle KK, Kirby D: Psychosocial predictors of delay of first sexual intercourse by adolescents. Health Psychol 1999, 18(5):443-452.
  • [28]Kaaya SF, Flisher AJ, Mbwambo JK, Schaalma HP, Aarø LE, Klepp KI: A review of studies of sexual behavior of school students in sub-Saharan Africa. Scand J Public Health 2002, 30:148-160.
  • [29]Heeren GA, Jemmott JB III, Mandeya A, Tyler JC: Theory-based predictors of condom use among university students in the United States and South Africa. AIDS Educ Prev 2007, 19(1):1-12.
  • [30]Giles M, Liddell C, Bydawell M: Condom use in African adolescents: The role of individual and group factors. AIDS Care 2005, 17:729-739.
  • [31]Bryan A, Kagee A, Broaddus MR: Condom use among South African adolescents: Developing and testing theoretical models of intentions and behavior. AIDS Behav 2006, 10:387-397.
  • [32]Lugoe W, Rise J: Predicting Intended Condom Use among Tanzanian Students using the Theory of Planned Behaviour. J Health Psychol 1999, 4(4):497-506.
  • [33]Meekers D, Klein M: Determinants of Condom Use among Young People in Urban Cameroon. Stud Fam Plann 2002, 33(4):335-346.
  • [34]Babalola S, Awasum D, Quenum-Renaud B: The correlates of safe sex practices among Rwandan youth: A positive deviance approach. African Journal of AIDS Research 2002, 1:11-21.
  • [35]Taffa N, Klepp KI, Sundby J, Bjune G: Psychosocial determinants of sexual activity and condom use intention among youth in Addis Ababa, Ethiopia. Int J STD AIDS 2002, 13:714-719.
  • [36]Paul-Ebhohimhen VA, Poobalan A, van Teijlingen ER: A systematic review of school-based sexual health interventions to prevent STI/HIB in sub-Saharan Africa. BMC Publ Health 2008, 8:4. BioMed Central Full Text
  • [37]Mũkoma W, Flisher AJ, Helleve A, Aarø LE, Mathews C, Kaaya S, Klepp KI: Development and test-retest reliability of a research instrument designed to evaluate school-based HIV/AIDS interventions in South Africa and Tanzania. Scand J Public Health 2009, 37(Suppl 2):7-15.
  • [38]Marindo R, Pearson S, Casterline JB: Condom use and abstinence among unmarried young people in Zimbabwe: Which strategy, Whose agenda? Report No. 170. New York: Policy Research Division, Population Council; 2003. Retrieved from: http://www.popcouncil.org/pdfs/wp/170.pdf webcite
  • [39]Kabiru CW, Ezeh A: Factors associated with sexual abstinence among adolescents in four sub-Saharan African Countries. Afr J Reprod Health 2007, 11(3):111-132.
  • [40]Cleland J, Ali MM: Sexual abstinence, contraception, and condom use by young African women: A secondary analysis of survey data. Lancet 2006, 368:1788-1793.
  • [41]Fekadu Z, Kraft P: Expanding the Theory of Planned Behaviour: The role of social norms and group identification. J Health Psychol 2002, 7:33-43.
  • [42]Bosompra K: Determinants of condom use intentions of university students in Ghana: An application of the theory of reasoned action. Soc Sci Med 2001, 52(7):1057-1069.
  • [43]Yeboah E, Maticka-Tyndale E: Factors influencing the timing of first sexual intercourse among young people in Nyanza, Kenya. Int Fam Plan Perspect 2008, 34(4):177-188.
  • [44]Benefo KD: Determinants of condom use in Zambia: A multilevel analysis. Stud Fam Plann 2010, 41(1):19-30.
  • [45]Adih WK, Alexander CS: Determinants of condom use to prevent HIV infection among youth in Ghana. J Adolesc Health 1999, 24:63-72.
  • [46]Ukwuani FA, Tsui AO, Suchindran CM: Condom use for preventing HIV infection/AIDS in sub-Saharan Africa: A comparative multilevel analysis of Uganda and Tanzania. J Acquir Immune Defic Syndr 2003, 34(2):203-213.
  • [47]Parker GP, Easton D, Klein H: Structural barriers and facilitators in HIV prevention: A review of international research. AIDS 2000, 14(Suppl 1):S22-S32.
  • [48]Gillespie S: AIDS, poverty, and hunger: Challenges and responses. Highlights of the International Conference on HIV/AIDS and Food and Nutrition Security, Durban, South Africa, 14–16 April 2005. Washington, D.C: International Food Policy Research Institute; 2006.
  • [49]Peters LWH, Wiefferink CH, Hoekstra F, Buijs GJ, ten Dam GTM, Paulussen TGWM: A review of similarities between domain-specific determinants of four health behaviors among adolescents. Health Educ Res 2009, 24(2):198-223.
  • [50]Schaalma HP, Abraham C, Gillmore MR, Kok G: Sex Education as Health Promotion: What Does It Take? Arch Sex Behav 2004, 33(3):259-269.
  • [51]Vermeer W, Bos AER, Mbwambo J, Kaaya S, Schaalma HP: Social and cognitive variables predicting voluntary HIV counseling and testing among Tanzanian medical students. Patient Educ Couns 2009, 75:135-140.
  • [52]Bos AER, Schaalma HP, Pryor JB: Reducing AIDS-related stigma in developing countries: The importance of theory- and evidence based interventions. Psychol Health Med 2008, 13(4):450-460.
  • [53]UNAIDS: Report on the global HIV/AIDS Epidemic. Geneva, Switzerland: UNAIDS; 2008.
  • [54]Karim AM, Magnani RJ, Morgan GT, Bond KC: Reproductive health risk and protective factors among unmarried youth in Ghana. Int Fam Plan Perspect 2003, 29(1):14-24.
  • [55]Bos AER, Kok G, Dijker AJ: Public reactions to people with HIV/AIDS in the Netherlands. AIDS Educ Prev 2001, 3:219-228.
  • [56]Stanton BF, Li X, Kahihuata J, Fitzgerald AM, Neumbo S, Kanduuombe G, Ricardo IB, Galbraith JS, Terreri N, Guevara I, Shipena H, Strijdom J, Clemens R, Zimba RF: Increased protected sex and abstinence among Namibian youth following a HIV risk-reduction intervention: a randomized, longitudinal study. AIDS 1998, 12:2473-2480.
  • [57]Mellanby AR, Rees JB, Tripp JH: Peer-led and adult-led school health education: a critical review of available comparative research. Health Educ Res 2000, 15:533-545.
  • [58]Stakic S, Zielony R, Bodiroza A, Kimzeke G: Peer education within a frame of theories and models of behaviour change. Entre Nous. The European Magazine for Sexual and Reproductive Health 2003, 56:4-6.
  • [59]Bluhm J, Volik M, Morgan N: Sexual health peer education among youth in Samara: the Russian Federation. Entre Nous: The European Magazine for Sexual and Reproductive Health 2003, 56:10-11.
  • [60]Walker SA, Avis M: Common reasons why peer education fails. J Adolesc 1999, 22(4):573-577.
  文献评价指标  
  下载次数:3次 浏览次数:14次