title: Determinants of consistent condom use among college students in China: application of the information-motivation-behavior skills (IMB) model.
abstract: BACKGROUND
  Due to the increase incidents of premarital sex and the lack of reproductive health services, college students are at high risk of HIV/AIDS infections in China. This study was designed to examine the predictors of consistency of condom use among college students based on the Information-Motivation-Behavioral Skills (IMB) model and to describe the relationships between the model constructs.
  
  
  METHODS
  A cross-sectional study was conducted to assess HIV/AIDS related information, motivation, behavioral skills and preventive behavior among college students in five colleges and universities in Nanjing, China. An anonymous questionnaire survey was conducted for data collection, and the structural equation model (SEM) was used to assess the IMB model.
  
  
  RESULTS
  A total of 3183 participants completed this study. The average age was 19.90 years (SD = 1.43, range 16 to 25). 342 (10.7%) participants of them reported having had premarital sex, among whom 30.7% reported having had a consistent condom use, 13.7% with the experience of abortion (including the participants whose sex partner has the same experience), 32.7% of participants had experience of multiple sex partners. The final IMB model provided acceptable fit to the data (CFI = 0.992, RMSEA = 0.028). Preventive behavior was significantly predicted by behavioral skills (β = 0.754, P<0.001). Information (β = 0.138, P<0.001) and motivation (β = 0.363, P<0.001) were indirectly affected preventive behavior, and was mediated through behavioral skills.
  
  
  CONCLUSIONS
  The results of the study demonstrate the utility of the IMB model for consistent condom use among college students in China. The main influencing factor of preventive behavior among college students is behavioral skills. Both information and motivation could affect preventive behavior through behavioral skills. Further research could develop preventive interventions based on the IMB model to promote consistent condom use among college students in China.
authors.affiliation: Institute for Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu Province, P.R. of China.
authors.forename: Zhihao
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Southeast University of China, Nanjing, Jiangsu Province, P.R. of China.
authors.forename: Pingmin
authors.initials: P
authors.lastname: Wei
authors.affiliation: Institute for Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu Province, P.R. of China.
authors.forename: Minghao
authors.initials: M
authors.lastname: Huang
authors.affiliation: Institute for Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu Province, P.R. of China.
authors.forename: Yuan bao
authors.initials: Yb
authors.lastname: Liu
authors.affiliation: Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Lucy
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, P.R. of China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Gong
authors.affiliation: Institute of Medical Information & Library, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, P.R. of China.
authors.forename: Juan
authors.initials: J
authors.lastname: Chen
authors.affiliation: Institute for Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu Province, P.R. of China.
authors.forename: Xiaoning
authors.initials: X
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data*; D003710:Demography; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D009042:Motivation; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D013334:Students / Q000706:statistics & numerical data*; D014495:Universities / Q000706:statistics & numerical data*; D055815:Young Adult