Midwest men's sex survey: the impact of norms, attitudes, and control factors on intentions and action planning to use condoms

This study assessed the relationship of variables from the Theory of Planned Behavior (TPB) with intentions to use condoms at next sex and action planning for condom use for main partners and for casual partners among an online of men who have sex with men (MSM) in a Midwestern state. The purpose of this study was to investigate variables of TPB among an online sample of HIV negative, Midwestern MSM and assess significant predictors of intentions separately by casual partners and main partners. Next, action planning was assessed as a potential variable to address the intention-behavior gap. The sample was recruited through an online social networking site, a lesbian, gay, bisexual, transgender (LGBT) - themed statewide newspaper and website. Participants completed an online survey that took 15-20 minutes to complete. Items assessed variables related to the TPB as well as action planning, stages of change, alternative strategies to reduce risk of HIV, and demographic variables including age, urban or rural residence, and HIV status. The results revealed that all TPB variables were strongly, significantly related for both casual and for main partners. The final regression models to predict intentions to use condoms at next sex accounted for 62% of the variance for main partners and 68% for casual partners. The regression models to predict action planning differed by partner type. For main partners, perceived behavioral control and intentions were significant predictors and explained 40% of the variance in action planning. For casual partners, self-efficacy was the significant predictor in the final model and explained 72% of the variance. Potential reasons for the differences in models by partner type for action planning are offered. Action planning is suggested as a potential mediating variable between intention and behavior that requires further research. Implications for HIV prevention interventions with MSM are discussed in light of reduced funding for low incidence states.