title: Predictors of consistent condom use based on the Information-Motivation-Behavior Skill (IMB) model among senior high school students in three coastal cities in China.
abstract: BACKGROUND
  High prevalence of risky sexual behaviors and lack of information, skills and preventive support mean that, adolescents face high risks of HIV/AIDS. This study applied the information-motivation-behavioral skills (IMB) model to examine the predictors of consistent condom use among senior high school students from three coastal cities in China and clarify the relationships between the model constructs.
  
  
  METHODS
  A cross-sectional study was conducted to assess HIV/AIDS related information, motivation, behavioral skills and preventive behaviors among senior high school students in three coastal cities in China. Structural equation modelling (SEM) was used to assess the IMB model.
  
  
  RESULTS
  Of the 12313 participants, 4.5% (95% CI: 4.2-5.0) reported having had premarital sex and among them 25.0% (95% CI: 21.2-29.1) reported having used a condom in their sexual debut. Only about one-ninth of participants reported consistent condom use. The final IMB model provided acceptable fit to the data (CFI = 0.981, RMSEA = 0.014). Consistent condom use was significantly predicted by motivation (β = 0.175, P < 0.01) and behavioral skills (β = 0.778, P < 0.01). Information indirectly predicted consistent condom use, and was mediated by behavioral skills (β = 0.269, P < 0.05).
  
  
  CONCLUSIONS
  The results highlight the importance of conducting HIV/AIDS preventive health promotion among senior high school students in China. The IMB model could predict consistent condom use and suggests that future interventions should focus on improving motivation and behavioral skills.
authors.affiliation: School of Public Health affiliated with School of Medicine, Shanghai Jiaotong University, No.227, South Chongqing Road, Shanghai 200025, PR China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Cai
authors.forename: Xiuxia
authors.initials: X
authors.lastname: Ye
authors.forename: Rong
authors.initials: R
authors.lastname: Shi
authors.forename: Gang
authors.initials: G
authors.lastname: Xu
authors.forename: Lixiao
authors.initials: L
authors.lastname: Shen
authors.forename: Jia
authors.initials: J
authors.lastname: Ren
authors.forename: Hong
authors.initials: H
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002681:China; D017280:Condoms; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015233:Models, Statistical; D009042:Motivation; D021841:Safe Sex / Q000523:psychology* / Q000706:statistics & numerical data*; D012649:Self Concept; D012725:Sexual Behavior / Q000706:statistics & numerical data; D013334:Students / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult