title: Relationship between social cognitive theory constructs and self-reported condom use: assessment of behaviour in a subgroup of the Safe in the City trial.
abstract: Previous studies have found social cognitive theory (SCT)-framed interventions are successful for improving condom use and reducing sexually transmitted infections (STIs). We conducted a secondary analysis of behavioural data from the Safe in the City intervention trial (2003-2005) to investigate the influence of SCT constructs on study participants' self-reported use of condoms at last intercourse.
  
  
  
  The main trial was conducted from 2003 to 2005 at three public US STI clinics. Patients (n=38,635) were either shown a 'safer sex' video in the waiting room, or received the standard waiting room experience, based on their visit date. A nested behavioural assessment was administered to a subsample of study participants following their index clinic visit and again at 3 months follow-up. We used multivariable modified Poisson regression models to examine the relationships among SCT constructs (sexual self-efficacy, self-control self-efficacy, self-efficacy with most recent partner, hedonistic outcome expectancies and partner expected outcomes) and self-reported condom use at last sex act at the 3-month follow-up study visit.
  
  
  
  Of 1252 participants included in analysis, 39% reported using a condom at last sex act. Male gender, homosexual orientation and single status were significant correlates of condom use. Both unadjusted and adjusted models indicate that sexual self-efficacy (adjusted relative risk (RRa)=1.50, 95% CI 1.23 to 1.84), self-control self-efficacy (RRa=1.67, 95% CI 1.37 to 2.04), self-efficacy with most recent partner (RRa=2.56, 95% CI 2.01 to 3.27), more favourable hedonistic outcome expectancies (RRa=1.83, 95% CI 1.54 to 2.17) and more favourable partner expected outcomes (RRa=9.74, 95% CI 3.21 to 29.57) were significantly associated with condom use at last sex act.
  
  
  
  Social cognitive skills, such as self-efficacy and partner expected outcomes, are an important aspect of condom use behaviour.
  
  
  
  clinicaltrials.gov (NCT00137370).
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Snead
authors.affiliation: Division of HIV/AIDS, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Ann M
authors.initials: AM
authors.lastname: O'Leary
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Michele G
authors.initials: MG
authors.lastname: Mandel
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Athena P
authors.initials: AP
authors.lastname: Kourtis
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wiener
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Lee
authors.initials: L
authors.lastname: Warner
authors.affiliation: California State University, Long Beach, California, USA.
authors.forename: C Kevin
authors.initials: CK
authors.lastname: Malotte
authors.affiliation: UCLA David Geffen School of Medicine and Fielding School of Public Health, Los Angeles, California, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
authors.affiliation: EDC, Waltham, Massachusetts, USA.
authors.forename: Lydia
authors.initials: L
authors.lastname: O'Donnell
authors.affiliation: Colorado School of Public Health, Denver, Colorado, USA.
authors.forename: Cornelis A
authors.initials: CA
authors.lastname: Rietmeijer
authors.affiliation: Division of HIV/AIDS, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Margolis
mesh_terms: D000328:Adult; D003071:Cognition; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D017533:Marital Status; D011582:Psychological Theory; D021841:Safe Sex; D020377:Self Efficacy; D057566:Self Report; D012737:Sex Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D019529:Sexuality; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D012927:Social Control, Informal; D055815:Young Adult
keywords: PUBLIC HEALTH; SEXUAL MEDICINE; SOCIAL MEDICINE