Stages of consistent condom use, partner intimacy, condom use attitude, and self-efficacy in African-American crack cocaine users

Abstract

This study examined how condom use attitude, self-efficacy, and partner intimacy related to five stages of consistent condom use. Interview data were collected from sexually active, heterosexual, African-American crack cocaine smokers (N = 366). Dependent measures assessed both the participants' own responses and their perceptions about their last sex partner's own personal condom use attitude and participants' condom use self-efficacy expectations. Partner intimacy was assessed both as a continuous attitudinal and as a discrete relationship measure. Less than 10% were classified as consistent condom users. Two thirds of inconsistent users were in the Precontemplation (PC) stage. The contemplation (C) and preparation (P) stages were equal among the remainder of the inconsistent condom users. Higher partner intimacy reduced modestly readiness for consistent condom use. The stage but not the intimacy group was related to the condom use attitudes and self-efficacy measures. Last partners' perceived own negative attitudes were significantly related to the stages of consistent condom use and was especially low in the action (A) and maintenance (M) stages. Participants' own negative attitudes were unrelated to the stages. Of the self-efficacy measures, both participants' performance and situational condom use self-efficacies increased significantly after the PC stage and were highest in the P, A, and M stages. However, situational self-efficacy accounted for most of performance self-efficacy variance. In sum, consistent condom use was rare. A partner's attitudes and the participants' own situational self-efficacy expectations, rather than intimacy, determined the readiness to adopt consistent condom use.

Fig. 1

Distribution of the three intimate partnership groups by stages of condom use with last partner

Fig. 2

Means of participants’ personal and their partner’s perceived negative condom use attitudes by stages of condom use with last partner. Note: Non-shared letters indicate a significant (p < .05) difference between stage means in Scheffé’s tests

Fig. 3

Means of participants’ condom use performance self-efficacy and situational self-efficacy by stages of condom use with last partner. Note: Non-shared letters indicate a significant (p < .05) difference between stage means in Scheffé’s tests