Background Previous studies have found Social Cognitive Theory (SCT)-framed interventions successful for improving condom use and reducing STIs. We conducted a secondary analysis of behavioural data from the Safe in The City trial to investigate the influence of social cognitive theory constructs on study participants’ self-reported use of condoms at last intercourse.
Methods The main trial was conducted (2003–2005) at three public U.S. sexually-transmitted infection (STI) clinics. Patients (n = 38,635) were either shown a safer sex video in the waiting room, or received the standard waiting room experience, based on their visit date. A nested behavioural assessment was administered to a subsample following their index clinic visit (n = 1,609) and at three months follow-up (n = 1,392). We used multivariable modified Poisson models to examine social cognitive theory constructs (sexual self-efficacy, self-control self-efficacy, self-efficacy with most recent partner, hedonistic outcome expectancies, and partner expected outcomes) and individual characteristics with self-reported condom use at last sex act.
Results Of 1252 participants included in analysis, 39% reported using a condom. Male gender, homosexual orientation and single status were significant predictors of condom use. Both unadjusted and adjusted [for demographic variables and study intervention (RR: 95% CI)] models indicate that sexual self-efficacy (1.50: 1.23–1.84), self-control self-efficacy (1.67: 1.37–2.04), self-efficacy with most recent partner (2.56: 2.01–3.27), more favourable hedonistic outcome expectancies (1.83: 1.54–2.17), and more favourable partner expected outcomes (9.74: 3.21–29.57) were significantly (p ≤ 0.001) associated with condom use at last sex act.
Conclusions Social cognitive theory constructs were significantly associated with condom use at last sex act, independent of the video intervention. Social cognitive skills, such as self-efficacy and partner expected outcomes, are an important aspect of condom use behaviour.
- condom use
- Social Cognitive Theory
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