HIV risk reduction for substance using seriously mentally ill adults: test of the information-motivation-behavior skills (IMB) model.
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).
Kalichman
Seth
S
Psychology Department, University of Connecticut, Storrs, CT 06269, USA. seth.k@uconn.edu
Malow
Robert
R
Dévieux
Jessy
J
Stein
Judith A
JA
Piedman
Fred
F
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*