Psychosocial determinants of condom use among Ghanaian students: An application of the theory of planned behavior and the health belief model

The study examined the applicability of the Theory of Planned Behavior (TPB), the Theory of Reasoned Action (TRA) and the Health Belief Model (HBM) to the study of condom use intentions of university students in Ghana. The data provided full support for the TPB when the constructs of the model were explicated with their direct measures. However, when the belief-based (indirect) measures of the constructs were used, the perceived behavioral control construct ceased to be a significant predictor of intention and the data provided only partial support for the TPB. The TPB explained up to 47.2%, the TRA, 45.9% and the HBM, 20% of the variance in students\u27 condom use intentions. A composite model comprising significant constructs of the TPB and the HBM successfully predicted 55.7% and 74.4% of male and female students\u27 intentions respectively. Subjective norm played a key role in the condom use intentions of the university students. Both intenders (those students who intended to use condoms consistently) and non-intenders (those who did not intend to use condoms) were equally motivated (or unmotivated) to comply with the wishes of their significant referents, in this case, sexual partners, close friends, parents and doctors. Thus, the critical difference between the intenders and the non-intenders was the belief that significant referents approved of condom use. There was also an important gender difference in the condom use intentions of the university students. Among the female students, in addition to the belief that significant referents approved of condom use, perceived severity of HIV/AIDS also significantly differentiated between intenders and non-intenders. The importance of subjective norm highlights the critical role that respondents\u27 social networks played in formulating the intention to use or not to use condoms. It is therefore recommended that AIDS education interventions targeting university students like those in this study should shift their foci away from individuals alone and instead, focus simultaneously on individuals and their social networks as one way of enhancing perceptions of significant referents\u27 acceptance of condom use