The main objectives of this study were to identify the determinants of condom use among HIV-positive men having anal sex with HIV-negative men or men of unknown HIV status and moderators of the intention–behaviour relationship. A cohort of 237 sexually active HIV-positive men having sex with men was followed over a period of six months. The cognitive variables measured were guided by an extended version of the theory of planned behaviour. Results indicated that past behaviour (odds ratio [OR] = 9.75; 95% confidence interval [CI]: 4.48–21.26), intention (OR = 3.13; 95% CI: 1.25–7.81), self-efficacy (OR = 3.62; 95% CI: 1.40–9.37) and use of sex drugs (OR = 0.16; 95% CI: 0.06–0.45) contributed to the prediction of 100% condom use. Self-efficacy also interacted with intention as a significant moderator of the intention–behaviour relationship (OR = 20.96; 95% CI: 2.90–151.51). Interventions promoting condom use should increase self-efficacy to use condoms and target users of sex drugs.
UNAIDS/WHO. AIDS Epidemic Update, Global Overview. Working Group on Global HIV/AIDS and STI Surveillance. 2007
2.
UNAIDS/WHO. Report on the Global AIDS Epidemic, Status of the Global HIV Epidemic. 2008
3.
LambertG, CoxJ, TremblayF, Sexual risk behaviours among men having sex with men (MSM) in Montreal: results from the ARGUS 2005 survey. Quebec: Canadian Association of HIV Research, 2006
4.
van KesterenNM, HospersHJ, KokG. Sexual risk behavior among HIV-positive men who have sex with men: a literature review. Patient Educ Counsel2007;65:5–20
5.
BaronRM, KennyDA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol1986;51:1173–82
6.
SheeranP, OrbellS. Do intentions predict condom use Meta-analysis and examination of six moderator variables. Br J Soc Psychol1998;37:231–50
7.
SheeranP, OrbellS. Augmenting the theory of planned behavior: roles for anticipated regret and descriptive norms. J Appl Soc Psychol1999;29:2107–42
8.
GodinG, ConnerM, SheeranP. Bridging the intention–behaviour ‘gap’: the role of moral norm. Br J Soc Psychol2005;44:497–512
9.
ArmitageCJ, ConnerM. Efficacy of the theory of planned behaviour: a meta-analytic review. Br J Soc Psychol2001;40:471–99
10.
SheeranP. Intention–behavior relations: a conceptual and empirical review. Eur Rev Soc Psychol2002;12:1–36
11.
AjzenI. The theory of planned behavior. Organ Behav Hum Dec Process1991;50:179–211
12.
GodinG, GagnonH, LambertLD, ConnerM. Determinants of condom use among a random sample of single heterosexual adults. Br J Health Psychol2005;10:85–100
13.
AlbarracinD, JohnsonBT, FishbeinM, MuellerleilePA. Theories of reasoned action and planned behavior as models of condom use: a meta-analysis. Psychol Bull2001;127:142–61
14.
KokG, HospersHJ, HarterinkP, De ZwartO. Social-cognitive determinants of HIV risk-taking intentions among men who date men through the Internet. AIDS Care2007;19:410–7
15.
GodinG, Maticka-TyndaleE, AdrienA, Cross-cultural testing of three social cognitive theories: an application to condom use. J Appl Soc Psychol1996;26:1556–86
16.
RenoRR, CialdiniRB, KallgrenCA. The transsituational influence of social norms. J Pers Soc Psychol1993;64:104–12
17.
TriandisHC. Value, Attitude and Interpersonal Behavior. Lincoln, NE: University of Nebraska, 1980
18.
BanduraA. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev1977;84:191–215
19.
SempleSJ, PattersonTL, GrantI. Psychosocial predictors of unprotected anal intercourse in a sample of HIV positive gay men who volunteer for a sexual risk reduction intervention. AIDS Educ Prev2000;12:416–30
20.
HoltgraveDR, CrosbyR, ShouseRL. Correlates of unprotected anal sex with casual partners: a study of gay men living in the southern United States. AIDS Behav2006;10:575–8
21.
GeorgeC, AlaryM, HoggRS, HIV and ethnicity in Canada: is the HIV risk-taking behaviour of young foreign-born MSM similar to Canadian born MSM?AIDS Care2007;19:9–16
22.
WilsonPA, CookS, McGaskeyJ, Situational predictors of sexual risk episodes among men with HIV who have sex with men. Sex Transm Infect2008;84:506–8
23.
BouhnikAD, PreauM, SchiltzMA, Unsafe sex with casual partners and quality of life among HIV-infected gay men: evidence from a large representative sample of outpatients attending French hospitals (ANRS-EN12-VESPA). J Acquir Immune Defic Syndr2006;42: 597–603
24.
StrathdeeSA, MartindaleSL, CornelissePGA, HIV infection and risk behaviours among young gay and bisexual men in Vancouver. Can Med Assoc J2000;162:21–5
25.
GodinG, KokG. The theory of planned behavior: a review of its applications to health-related behaviors. Am J Health Promot1996;11:87–98
26.
New England Research Institutes. Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQOL-HIV). New England Research Institutes, 1997
27.
SherbourneCD, StewartAL. The MOS social support survey. Soc Sci Med1991;32:705–14
28.
CronbachLJ. Coefficient alpha and the internal structure of tests. Psychometrika1951;16:297–334
29.
von HaeftenI, FishbeinM, KasprzykD, MontanoDE. Analyzing data to obtain information to design targeted interventions. Psychol Health Med2001;6:151–64
30.
HosmerDW, LemeshowS. Applied Logistic Regression. New York: John Wiley & Sons, 2000
31.
CaseyMK, TimmermannL, AllenM, Response and self-efficacy of condom use: a meta-analysis of this important element of AIDS education and prevention. South Commun J2009;74:57–78
32.
MinerMH, PetersonJL, WellesSL, How do social norms impact HIV sexual risk behavior in HIV-positive men who have sex with men? Multiple mediator effects. J Health Psychol2009;14:761–70
33.
TrafimowD, SheeranP, ConnerM, FinlayKA. Evidence that perceived behavioural control is a multidimensional construct: perceived control and perceived difficulty. Br J Soc Psychol2002;41:101–21
34.
WulfertE, WanCK. Condom use: a self-efficacy model. Health Psychol1993;12:346–53
35.
ManserghG, ShouseRL, MarksG, Methamphetamine and sildenafil (Viagra) use are linked to unprotected receptive and insertive anal sex, respectively, in a sample of men who have sex with men. Sex Transm Infect2006;82:131–4
36.
SwearingenSG, KlausnerJD. Sildenafil use, sexual risk behavior, and risk for sexually transmitted diseases, including HIV infection. Am J Med2005;118:571–7
37.
HirshfieldS, RemienRH, HumberstoneM, Substance use and high-risk sex among men who have sex with men: a national online study in the USA. AIDS Care2004;16:1036–47
38.
SpindlerHH, ScheerS, ChenSY, Viagra, methamphetamine, and HIV risk: results from a probability sample of MSM, San Francisco. Sex Transm Dis2007;34:586–91
39.
ChuPL, McFarlandW, GibsonS, Viagra use in a community-recruited sample of men who have sex with men, San Francisco. J Acquir Immune Defic Syndr2003;33:191–3
40.
JohnsonWD, DiazRM, FlandersWD, Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. Cochrane Database of Systematic Reviews2008: CD001230
41.
Von HaeftenI, FishbeinM, KasprzykD, MontanoD. Analyzing data to obtain information to design targeted interventions. Psychol Health Med2001;6:151–64
