Individual, interpersonal, and community predictors of consistent condom use among Taiwanese university students

Gender disparities in attitudes, norms, and perceived control related to intentional condomless sexual intercourse: A psychosocial theory-driven comparison among cisgender heterosexual male and female college varsity athletes in Taiwan

Background

While condom use has been extensively studied as a protective behavior, research directly focusing on condomless sexual intercourse (CSI) as a distinct and intentional risk behavior, particularly regarding gender differences, remains scarce.

Methods

Building upon the Theory of Planned Behavior (TPB), this study addresses this gap by comparing TPB factors and individual TPB items regarding intentional CSI among cisgender heterosexual college varsity athletes in Taiwan (N = 1348).

Results

High CSI intention was more prevalent among men (53.6 %) than women (31.7 %). Our expanded TPB framework identified five distinct TPB factors pertaining to attitudes, norms, and perceived control. Multivariate logistic regression analysis demonstrated that all five TPB factors were significantly associated with CSI intention among men, but only three among women. Notably, our factor analysis differentiated attitudes toward positive/negative outcomes of CSI and perceived control under facilitating/constraining conditions, revealing attitudes toward positive outcomes of CSI as the strongest driver of CSI intention among both men (AOR = 2.51-4.09) and women (AOR = 3.79-5.71). Further analysis of TPB items disclosed that men prioritized psychological pleasure (AOR = 2.18), whereas women exhibited a "partner-centered" tendency, emphasizing trust by sex partners (AOR = 3.43).

Conclusions

Overall, men exhibited more favorable views toward CSI than women, with gender differences evident in the differential associations of varying TPB factors and items with CSI intention. Future research could explore the development of these differential attitudes, norms, and perceived control concerning CSI. Given the modifiable nature of TPB variables, our study's insights can inform actionable strategies and targeted interventions tailored for young men and women.

Measurement of Social Norms Affecting Modern Contraceptive Use: A Literature Review

As a critical building block to developing social norms interventions to support healthy family planning and other reproductive health behaviors, we conducted a literature review to identify and evaluate social norm measures related to modern contraceptive use. Of 174 articles reviewed in full, only 17 studies met our criteria for inclusion. Across these articles, no single measure of norms was used in more than one study; failure to specify the boundaries of who was engaging in and influencing the behaviors of interest contributed to the variation. Most of the studies relied on cross-sectional data, only included condom use as their contraceptive use outcome, used individual- or interpersonal-level behavior change theories rather than social-level theories, and assumed a reference group, all of which limit the quality of the norm measures. We make several recommendations to bring greater consistency and comparability to social norm measures.