title: HIV risk reduction for substance using seriously mentally ill adults: test of the information-motivation-behavior skills (IMB) model.
abstract: The information-motivation-behavioral skills (IMB) model (Fisher & Fisher, 1992) was used as the theoretical framework for predicting unprotected sexual behavior among substance abusing men and women diagnosed with serious mental illnesses (n = 320; 150 men and 170 women, primarily of minority ethnicity). In a structural equation model, gender, HIV transmission knowledge, and motivational variables of pro-condom norms and attitudes, and perceived susceptibility predicted behavioral skills markers: condom use skills and condom use self-efficacy. Along with the other variables in the model, condom skills and condom self-efficacy were hypothesized to predict condom use over a six-month period. Results showed that greater condom skills were predicted by female gender, positive condom attitudes, and transmission knowledge. Engaging in lower rates of unprotected sex was predicted by pro-condom norms, less perceived susceptibility, and greater condom self-efficacy. Positive attitudes toward condoms had a significant indirect effect on rates of unprotected sex, exerting its influence through condom use self-efficacy. Results suggest that changing personal attitudes about condoms and reinforcing pro-condom attitudes among significant others will encourage condom use among seriously mentally ill (SMI) adults who are at high risk for HIV and other sexually transmitted diseases (STDs).
authors.affiliation: Psychology Department, University of Connecticut, Storrs, CT 06269, USA. seth.k@uconn.edu
authors.forename: Seth
authors.initials: S
authors.lastname: Kalichman
authors.forename: Robert
authors.initials: R
authors.lastname: Malow
authors.forename: Jessy
authors.initials: J
authors.lastname: Dévieux
authors.forename: Judith A
authors.initials: JA
authors.lastname: Stein
authors.forename: Fred
authors.initials: F
authors.lastname: Piedman
mesh_terms: D000328:Adult; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005431:Florida; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology*; D008875:Middle Aged; D008960:Models, Psychological; D040242:Risk Reduction Behavior; D021841:Safe Sex; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology*