ORIGINAL PAPER Sociocognitive Predictors of Condom Use and Intentions Among Adolescents in Three Sub-Saharan Sites

Abstract Many HIV intervention programs in sub-Saharan Africahaveapplied social cognitive theories suchas the theory of planned behavior. However, a recent sub-Saharan African reviewwas unable to show increased effectiveness for theory-based interventions. This studyassessedwhether the predictive value of attitudes, subjective norms, self-efficacy, and intention was similar to studies in Europe and theU.S., andwhether there were differences between three sub-Saharan sites. Longitudinal multigroup structural equation modeling was used to assess whether attitudes, subjective norms, and self-efficacy predicted condom use intentions and condom use (after 6months) among adolescents in threesites,namelyCapeTown(SouthAfrica;N= 625), Dar es Salaam (Tanzania;N = 271), andMankweng (SouthAfrica;N=404). Condomuse intentionswere predicted by subjective norms and self-efficacy in all three sites. Attitudes were not related to intentions in Dar es Salaam and were mod-erately related to intentions in Cape Town andMankweng. The proportionsofexplainedvariance in intentionsandbehaviorwere decent (37–52 and 9–19%, respectively). Although significant differences in predictive value were found between sites and in comparison to European and U.S. studies, intentions could adequatelybe explainedbyattitudes, subjectivenorms, and self-efficacy. However, the limited proportions of variance in be-havior explained by intentions could signify the importance of contextual and environmental factors. Future studies are rec-ommended tousean integrativeapproach that takes intoaccount both individual and contextual factors, as well as social and en-vironmental differences