title: Attitude as a Mediator between Acculturation and Behavioral Intention.
abstract: Immigrants, specifically African-born black persons, are affected by the HIV epidemic in the U.S. The low level of condom use among immigrants is a risk factor for contracting HIV and STIs. Immigrants go through acculturation process in their new adopted countries-a process reported to influence many health risks and protective factors; however, the mechanism through which acculturation influences health behaviors is not well understood. Thus, study examined the mediating role of attitude in the relationship between acculturation and the intention to use male condoms in steady heterosexual relationships among Somali and Ethiopian immigrants in Minnesota.
  
  
  
  The study was a regression analysis and the method of data collection cross-sectional. Participants were (n = 205) Somali and Ethiopian immigrants in Minnesota who volunteered for the study.
  
  
  
  Study participants responded to questions on attitudes, behavioral intention, and acculturation levels.
  
  
  
  The indirect effect of acculturation through the mediator, attitude, was not significant, product coefficient (a × b) = 0.04, 95% CI: [0.00, 0.11]; hence attitude did not mediate the relationship between acculturation and the intention to use condoms in the study population. However, there were significant direct and total effects of acculturation (c' = .27, p < .05; c = .31, p < .05), respectively, on intention to use condoms.
  
  
  
  Results of the study may suggest that public health intervention strategies targeting condom use among immigrants should incorporate programs that improve English language training tailored to the cultural practices and values of the immigrants, and consider the effect of acculturation on condom use.
authors.affiliation: Department of Public Health, Keimyung University, South Korea, Daegu, South Korea.
authors.forename: Nasser B
authors.initials: NB
authors.lastname: Ebrahim
authors.affiliation: Department of Surgery, Paul L Foster School of Medicine, Texas Tech Health Center, El Paso, Texas.
authors.forename: Sharon
authors.initials: S
authors.lastname: Davis
authors.affiliation: Department of Public Health Sciences, College of Health and Social Services Interim Department Head, New Mexico State University, Las Cruces, New Mexico.
authors.forename: Joe
authors.initials: J
authors.lastname: Tomaka
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D000368:Aged; D001290:Attitude; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005002:Ethiopia / Q000208:ethnology; D005260:Female; D015438:Health Behavior; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D012749:Sexually Transmitted Diseases; D012998:Somalia / Q000208:ethnology; D055815:Young Adult
keywords: 
  HIV
  ; acculturation; attitude; condoms; immigrants; intention; mediation