Skip to main content

Advertisement

SpringerLink
Log in

Does the Theory of Planned Behaviour Explain Condom Use Behaviour Among Men Who have Sex with Men? A Meta-analytic Review of the Literature

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

The aim of this meta-analysis was to explore whether the constructs in the theory of planned behaviour (TPB; i.e., attitude, subjective norm, perceived behavioural control, intention) explain condom use behaviour among men who have sex with men (MSM). Electronic databases were searched for studies that measured TPB variables and MSM condom use. Correlations were meta-analysed using a random effects model and path analyses. Moderation analyses were conducted for the time frame of the behavioural measure used (retrospective versus prospective). Attitude, subjective norm and perceived behavioural control accounted for 24.0 % of the variance in condom use intention and were all significant correlates. Intention and PBC accounted for 12.4 % of the variance in condom use behaviour. However, after taking intention into account, PBC was no longer significantly associated with condom use. The strength of construct relationships did not differ between retrospective and prospective behavioural assessments. The medium to large effect sizes of the relationships between the constructs in the TPB, which are consistent with previous meta-analyses with different behaviours or target groups, suggest that the TPB is also a useful model for explaining condom use behaviour among MSM. However, the research in this area is rather small, and greater clarity over moderating factors can only be achieved when the literature expands.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. HIV in the United States: at a glance 2013 [updated 3 December, 2013; cited 2014 24 February]. http://www.cdc.gov/hiv/statistics/basics/ataglance.html].

  2. European Centre for Disease Prevention and Control/WHO Regional Office for Europe. HIV/AIDS surveillance in Europe 2012. Stockholm: European Centre for Disease Prevention and Control, 2013.

  3. The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia annual surveillance report. 2013. The Kirby Institute, The University of New South Wales, Sydney 2052.

  4. Prejean J, Song R, Hernandez A, Ziebell R, Green T, Walker F, et al. Estimated HIV incidence in the United States, 2006–2009. PLoS ONE. 2011;6:e17502.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Centers for Disease Control and Prevention. HIV Surveillance Report, 2013 2015 [updated July 9 2015; cited 2015 July 10]. http://www.cdc.gov/hiv/library/reports/surveillance/.

  6. Sullivan PS, Jones JS, Baral SD. The global north: HIV epidemiology in high-income countries. Curr Opin HIV AIDS. 2014;9(2):199–205.

    Article  PubMed  Google Scholar 

  7. Beyrer C, Baral S, van Griensven F, Goodreau S, Chariyalertsak S, Wirtz A, Brookmeyer R. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380(9839):367–77.

    Article  PubMed  PubMed Central  Google Scholar 

  8. De Wit J, Adam P. Revolution or evolution? What can approaches based on the use of antiretroviral drugs contribute to HIV prevention in gay communities in high-income countries. In: Eaton LA, Kalichman SC, editors. Biomedical advances in HIV prevention. TBA. New York: Springer; 2014.

    Google Scholar 

  9. World Health Organisation. HIV/AIDS: Key Facts 2014 [updated October 2013; cited 2014 20 February]. http://www.who.int/mediacentre/factsheets/fs360/en/.

  10. Bruce D, Harper GW, Suleta K. Sexual risk behavior and risk reduction beliefs among HIV-positive young men who have sex with men. AIDS Behav. 2013;17(4):1515–23.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Grov C. HIV risk and substance use in men who have sex with men surveyed in bathhouses, bars/clubs, and on Craigslist.org: venue of recruitment matters. AIDS Behav. 2012;16(4):807–17.

    Article  PubMed  Google Scholar 

  12. Grov C, Rendina HJ, Ventuneac A, Parsons JT. HIV risk in group sexual encounters: an event-level analysis from a national online survey of MSM in the US. J Sex Med. 2013;10(9):2285–94.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Rosenberger JG, Reece M, Schick V, Herbenick D, Novak DS, Van Der Pol B, et al. Condom use during most recent anal intercourse event among a US sample of men who have sex with men. J Sex Med. 2012;9(4):1037–47.

    Article  PubMed  Google Scholar 

  14. Kalichman SC, Eaton L, Cain D, Cherry C, Fuhrel A, Kaufman M, et al. Changes in HIV treatment beliefs and sexual risk behaviors among gay and bisexual men, 1997–2005. Health Psychol. 2007;26(5):650–6.

    Article  PubMed  Google Scholar 

  15. Zablotska IB, Prestage G, Middleton M, Wilson D, Grulich AE. Contemporary HIV diagnoses trends in Australia can be predicted by trends in unprotected anal intercourse among gay men. AIDS. 2010;24(12):1955–8.

    Article  PubMed  Google Scholar 

  16. Osmond DH, Pollack LM, Paul JP, Catania JA. Changes in prevalence of HIV infection and sexual risk behavior in men who have sex with men in San Francisco: 1997–2002. Am J Public Health. 2007;97(9):1677–83.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Herbst JH, Sherba RT, Crepaz N, DeLuca JB, Zohrabyan L, Stall RD, et al. A meta-analytic review of HIV behavioral interventions for reducing sexual risk behavior of men who have sex with men. J Acquir Immune Defic Syndr. 2005;39(2):228–41.

    PubMed  Google Scholar 

  18. Turchik JA, Gidycz CA. Exploring the intention-behavior relationship in the prediction of sexual risk behaviors: can it be strengthened? J Sex Res. 2012;49(1):50–60.

    Article  PubMed  Google Scholar 

  19. Albarracin D, Durantini M, Earl A. Empirical and theoretical conclusions of an analysis of outcomes of HIV-prevention interventions. Curr Dir Psychol Sci. 2006;15(2):73–8.

    Article  Google Scholar 

  20. Sniehotta F, Presseau J, Araujo-Soares V. Time to retire the theory of planned behaviour. Health Psychol Rev. 2014;8(1):1–7.

    Article  PubMed  Google Scholar 

  21. Armitage C, Conner M. Efficacy of the theory of planned behaviour: a meta-analytic review. Br J Soc Psychol. 2001;40:471–99.

    Article  CAS  PubMed  Google Scholar 

  22. Conner M, Sparks P. Theory of planned behaviour and health behaviour. In: Conner M, Norman P, editors. Predicting health behaviour. 2nd ed. Maidenhead: Open University Press; 2005. p. 170–222.

    Google Scholar 

  23. Guillaumie L, Godin G, Vézina-Im L-A. Psychosocial determinants of fruit and vegetable intake in adult population: a systematic review. Int J Behav Nutr Phys Act. 2010;7(1):7–12.

    Article  Google Scholar 

  24. Montanaro EA, Bryan AD. Comparing theory-based condom interventions: health belief model versus theory of planned behavior. Health Psychol. 2014;33(10):1251–60.

    Article  PubMed  Google Scholar 

  25. McEachan RRC, Conner M, Taylor NJ, Lawton RJ. Prospective prediction of health-related behaviours with the theory of planned behaviour: a meta-analysis. Health Psychol Rev. 2011;5(2):97–144.

    Article  Google Scholar 

  26. Godin G, Savard J, Kok G, Fortin C, Boyer R. HIV seropositive gay men: understanding adoption of safe sexual practices. AIDS Educ Prev. 1996;8(6):529–45.

    CAS  PubMed  Google Scholar 

  27. De Wit JB, Stroebe W, De Vroome EM, Sandfort TG, Van Griensven GJ. Understanding AIDS preventive behavior with casual and primary partners in homosexual men: the theory of planned behavior and the information-motivation-behavioral-skills model. Psychol Health. 2000;15(3):325–40.

    Article  Google Scholar 

  28. Albarracin D, Johnson B, Fishbein M, Muellerleile P. Theories of reasoned action and planned behavior as models of condom use: a meta-analysis. Psychol Bull. 2001;127(142–161):142–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Fishbein M. A theory of reasoned action: some applications and implications. Nebr Symp Motiv. 1979;27:65–116.

    Google Scholar 

  30. Sutton S. The past predicts the future: interpreting behaviour-behaviour relationships in social psychological models of health behaviour. In: Rutter D, Quine L, editors. Social psychology and health: European perspectives. Brookfield: Averbury/Ashgate Publishing Co; 1994. p. 71–88.

    Google Scholar 

  31. Norman P, Conner M. The theory of planned behaviour and binge drinking: assessing the moderating role of past behaviour within the theory of planned behaviour. Br J Health Psychol. 2006;11(1):55–70.

    Article  PubMed  Google Scholar 

  32. Rhodes R, Courneya K. Modelling the theory of planned behaviour and past behaviour. Psychol Health Med. 2007;8(1):57–69.

    Article  Google Scholar 

  33. Norman P, Conner M, Bell R. The theory of planned behaviour and exercise: evidence for the moderating role of past behaviour. Br J Health Psychol. 2000;5(3):249–61.

    Article  Google Scholar 

  34. Ajzen I. Residual effects of past on later behavior: habituation and reasoned action perspectives. Personal Soc Psychol Rev. 2002;6(2):107–22.

    Article  Google Scholar 

  35. Albarracin D, Gillette J, Earl A, Glasman L, Durantini M, Ho M. A test of major assumptions about behavior change: a comprehensive look at the effects of passive and active HIV-prevention interventions since the beginning of the epidemic. Psychol Bull. 2005;131(6):856–97.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Sheeran P, Orbell S. Do intentions predict condom use? Meta-analysis and examination of six moderator variables. Br J Soc Psychol. 1998;37:231–50.

    Article  PubMed  Google Scholar 

  37. Albarracin D, Fishbein M, Middlestadt S. Generalizing behavioral findings across times, samples, and measures: a study of condom use. J Appl Soc Psychol. 1998;28(8):657–74.

    Article  Google Scholar 

  38. Merlin JS, Cen L, Praestgaard A, Turner M, Obando A, Alpert C, et al. Pain and physical and psychological symptoms in ambulatory HIV patients in the current treatment era. J Pain Symptom Manag. 2012;43(3):638–45.

    Article  Google Scholar 

  39. Begley K, Chan D, Jeganathan S, Batterham M, Smith D. Correlates of unprotected anal intercourse in HIV positive men attending an HIV/AIDS clinic in Sydney. Curr HIV Res. 2008;6:579–84.

    Article  CAS  PubMed  Google Scholar 

  40. Cassell M, Halperin D, Shelton J, Stanton D. HIV and risk behaviour: risk compensation: the Achilles’ heel of innovations in HIV prevention? Br Med J. 2006;332(7541):605–7.

    Article  Google Scholar 

  41. Eaton LA, Kalichman SC. Risk compensation in HIV prevention: implications for vaccines, microbicides, and other biomedical HIV prevention technologies. Curr HIV/AIDS Rep. 2007;4(4):165–72.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Kalichman SC, Cherry C, Cain D, Pope H, Kalichman M, Eaton L, et al. Internet-based health information consumer skills intervention for people living with HIV/AIDS. J Consult Clin Psychol. 2006;74(3):545–54.

    Article  PubMed  Google Scholar 

  43. Moher D, Liberati A, Tetzlaff J, Altman D. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(6):e1000097.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Furlan AD, Pennick V, Bombardier C, van Tulder M. 2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group. Spine. 2009;34(18):1929–41.

    Article  PubMed  Google Scholar 

  45. Cook DJ, Guyatt GH, Ryan G, Clifton J, Buckingham L, Willan A, et al. Should unpublished data be included in meta-analyses? Current convictions and controversies. J Am Med Assoc. 1993;269(21):2749–53.

    Article  CAS  Google Scholar 

  46. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF, et al. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Lancet. 1999;354(9193):1896–900.

    Article  CAS  PubMed  Google Scholar 

  47. Dickersin K. The existence of publication bias and risk factors for its occurrence. J Am Med Assoc. 1990;263(10):1385–9.

    Article  CAS  Google Scholar 

  48. Easterbrook PJ, Gopalan R, Berlin J, Matthews DR. Publication bias in clinical research. Lancet. 1991;337(8746):867–72.

    Article  CAS  PubMed  Google Scholar 

  49. Ferguson CJ, Heene M. A vast graveyard of undead theories publication bias and psychological science’s aversion to the null. Perspect Psychol Sci. 2012;7(6):555–61.

    Article  PubMed  Google Scholar 

  50. Schutz M, Godin G, Kok G, Vezina-lm L, Naccache H, Otis J, MAYA Study Group. Determinants of condom use among HIV-positive men who have sex with men. Int J STD AIDS. 2011;22(7):391–7.

    Article  CAS  PubMed  Google Scholar 

  51. Biostat. Comprehensive meta-analysis. 2nd ed. Englewood: Biostat; 2005.

    Google Scholar 

  52. Arbuckle JL. Amos (Version 22.0) [Computer Program]. Chigaco: SPSS; 2013.

    Google Scholar 

  53. Colquitt JA, LePine JA, Noe RA. Toward an integrative theory of training motivation: a meta-analytic path analysis of 20 years of research. J Appl Psychol. 2000;85(5):678.

    Article  CAS  PubMed  Google Scholar 

  54. Eby LT, Freeman DM, Rush MC, Lance CE. Motivational bases of affective organizational commitment: a partial test of an integrative theoretical model. J Occup Organ Psychol. 1999;72(4):463–83.

    Article  Google Scholar 

  55. Hedges LV, Vevea JL. Fixed-and random-effects models in meta-analysis. Psychol Methods. 1998;3(4):486–504.

    Article  Google Scholar 

  56. Hedges LV. Meta-analysis. J Educ Behav Stat. 1992;17(4):279–96.

    Article  Google Scholar 

  57. Viechtbauer W. Conducting meta-analyses in R with the metaphor package. J Stat Softw. 2010;36(3):1–48.

    Article  Google Scholar 

  58. Field AP. Meta-analysis of correlation coefficients: a Monte Carlo comparison of fixed-and random-effects methods. Psychol Methods. 2001;6(2):161–80.

    Article  CAS  PubMed  Google Scholar 

  59. Schmidt FL, Oh IS, Hayes TL. Fixed-versus random-effects models in meta-analysis: model properties and an empirical comparison of differences in results. Br J Math Stat Psychol. 2009;62(1):97–128.

    Article  PubMed  Google Scholar 

  60. Cohen J. A power primer. Psychol Bull. 1992;112(1):155–9.

    Article  CAS  PubMed  Google Scholar 

  61. Fisher R. On the ‘probable error’ of a coefficient of correlation deduced from a small sample. Metron. 1921;1:1–32.

    Google Scholar 

  62. Silver NC, Dunlap WP. Averaging correlation coefficients: should Fisher’s z transformations be used? J Appl Psychol. 1987;72(1):146–8.

    Article  Google Scholar 

  63. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. Br Med J. 2003;327(7414):557–60.

    Article  Google Scholar 

  64. Gavaghan DJ, Moore RA, McQuay HJ. An evaluation of homogeneity tests in meta-analyses in pain using simulations of individual patient data. Pain. 2000;85(3):415–24.

    Article  CAS  PubMed  Google Scholar 

  65. Huedo-Medina TB, Sánchez-Meca J, Marín-Martínez F, Botella J. Assessing heterogeneity in meta-analysis: Q statistic or I 2 index? Psychol Methods. 2006;11(2):193–206.

    Article  PubMed  Google Scholar 

  66. Ioannidis JP, Trikalinos TA. The appropriateness of asymmetry tests for publication bias in meta-analyses: a large survey. Can Med Assoc J. 2007;176(8):1091–6.

    Article  Google Scholar 

  67. Terrin N, Schmid CH, Lau J, Olkin I. Adjusting for publication bias in the presence of heterogeneity. Stat Med. 2003;22(13):2113–26.

    Article  PubMed  Google Scholar 

  68. Rosario M, Mahler K, Hunter J, Gwadz M. Understanding the unprotected sexual behaviors of gay, lesbian, and bisexual youths: an empirical test of the cognitive-environmental model. Health Psychol. 1999;18(3):272.

    Article  CAS  PubMed  Google Scholar 

  69. Franssens D, Hospers HJ, Kok G. Social-cognitive determinants of condom use in a cohort of young gay and bisexual men. AIDS Care. 2009;21(11):1471–9.

    Article  PubMed  Google Scholar 

  70. Godin G, MatickaTyndale E, Adrien A, MansonSinger S, Willms D, Cappon P. Cross-cultural testing of three social cognitive theories: an application to condom use. J Appl Soc Psychol. 1996;26(17):1556–86.

    Article  Google Scholar 

  71. De Vroome E, Stroebe W, Sandfort T, De Wit J, Griensven G. Safer sex in social context: Individualistic and relational determinants of AIDS-preventive behavior among gay men. J Appl Soc Psychol. 2000;30(11):2322–40.

    Article  Google Scholar 

  72. Rye BJ, Fisher WA, Fisher JD. The theory of planned behavior and safer sex behaviors of gay men. AIDS Behav. 2001;5(4):307–17.

    Article  Google Scholar 

  73. Fishbein M, Ajzen I. Predicting and changing behavior: the reasoned action approach. New York: Psychology Press; 2010.

    Google Scholar 

  74. Ajzen I, Fishbein M. Attitude-behavior relations: a theoretical analysis and review of empirical research. Psychol Bull. 1977;84(5):888–918.

    Article  Google Scholar 

  75. Schwarzer R, Luszczynska A. How to overcome health-compromising behaviors: the health action process approach. Eur Psychol. 2008;13(2):141–51.

    Article  Google Scholar 

  76. Schwarzer R. Self-efficacy in the adoption and maintenance of health behaviors: theoretical approaches and a new model. In: Schwarzer R, editor. Self-efficacy thought control of action. Washington, DC: Hemisphere; 1992. p. 217–43.

    Google Scholar 

  77. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50:179–211.

    Article  Google Scholar 

  78. Ko N-Y, Lee H-C, Hung C-C, Chang J-L, Lee N-Y, Chang C-M, et al. Effects of structural intervention on increasing condom availability and reducing risky sexual behaviours in gay bathhouse attendees. AIDS Care. 2009;21(12):1499–507.

    Article  PubMed  Google Scholar 

  79. Ouellette J, Wood W. Habit and intention in everyday life: the multiple processes by which past behavior predicts future behavior. Psychol Bull. 1998;124(1):54–74.

    Article  Google Scholar 

  80. Prabawanti C, Dijkstra A, Riono P, Tb GH. Preparatory behaviours and condom use during receptive and insertive anal sex among male-to-female transgenders (Waria) in Jakarta, Indonesia. J Int AIDS Soc. 2014;17(1):1–7.

    Article  Google Scholar 

  81. Waldo CR, Coates TJ. Multiple levels of analysis and intervention in HIV prevention science: exemplars and directions for new research. AIDS. 2000;14:18–26.

    Article  Google Scholar 

  82. Dickersin K, Min Y-I, Meinert CL. Factors influencing publication of research results: follow-up of applications submitted to two institutional review boards. J Am Med Assoc. 1992;267(3):374–8.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

Thanks are due to BJ Rye, Dirk Franssens, John de Wit and Wolfgang Stroebe for providing information or data for this meta-analysis.

Author information

Authors and Affiliations

  1. School of Psychology, University of Sydney, Sydney, Australia

    Benjamin J. Andrew, Barbara A. Mullan, Lauren A. Monds & Jemma Todd

  2. School of Psychology and Speech Pathology, Curtin University, GPO BOX U1987, Perth, WA, 6845, Australia

    Barbara A. Mullan

  3. Centre for Social Research in Health, UNSW, Sydney, Australia

    John B. F. de Wit

  4. School of Psychology, Deakin University, Geelong, Australia

    Emily J. Kothe

Authors
  1. Benjamin J. Andrew
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Barbara A. Mullan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John B. F. de Wit
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lauren A. Monds
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jemma Todd
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Emily J. Kothe
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Barbara A. Mullan.

Ethics declarations

Conflict of Interest

The authors have no sources of funding or conflicts of interest to disclose.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Andrew, B.J., Mullan, B.A., de Wit, J.B.F. et al. Does the Theory of Planned Behaviour Explain Condom Use Behaviour Among Men Who have Sex with Men? A Meta-analytic Review of the Literature. AIDS Behav 20, 2834–2844 (2016). https://doi.org/10.1007/s10461-016-1314-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-016-1314-0

Keywords

Search

Navigation