The application of psychosocial factors to HIV risk among belizean adolescents

Psychosocial factors within the context of behavioral models have been widely used to explain sexual risk behavior among adolescents in the united states. we examined the cross-cultural relevance of psychosocial factors to hiv-risk behavior among adolescents in belize.

health behavior is often too complex to be addressed by any single existing theory. we therefore, incorporated elements from the health belief model, the theory of reasoned action, and social cognitive theory to guide the development of this research. researchers have already identified several elements of these models as being important precursors to behavioral change among adolescents in the united states. these factors include attitudes about condom use and sex 1, 2, intentions to use condoms 1, 2, peer norms regarding sex and condom use 1, 3, self-efficacy for condom use 2, 4, and perceived risk for contracting hiv 1, 4. in the current study, we examined the relevance of these psychosocial factors to abstinence and condom use (for sexually active adolescents). based on the review of the literature, we hypothesized that the following variables would be associated with condom use among sexually active adolescents: intentions to use condoms, attitudes towards condoms, peer norms/pressure, parent-child communication, self-efficacy for condom use, and perceived risk for contracting hiv.

students (n = 150 in grades 8–12, 63% female) from six schools in belize city, belize completed a self-administered questionnaire in a classroom setting. fifty-eight percent of respondents reported having a steady girlfriend or boyfriend, and 34.6% of respondents reported being sexually experienced. of the latter, 27% were age 12 years or younger and 48% were age 13 or 14 years when they had sexual intercourse for the first time. approximately 40% of respondents had three or more lifetime sexual partners. forty-five percent of sexually active respondents reported having sex with their main partner and a partner other than their main partner or multiple partners in the past six months. fifty-four percent of respondents report that they do not always use condoms when having sexual intercourse. males were more likely to have engaged in sexual intercourse than females (or = 4.5). older respondents were more likely than younger respondents to have engaged in sexual intercourse (or = 2.6).

intention to use condoms was positively correlated with condom use (r = .41, p < .01). there was a positive correlation between attitude towards condoms and condom use (r = .29, p < .05). respondents who self-reported feeling pressured into having sexual intercourse by someone they really liked were more likely to have engaged in sexual intercourse than respondents who did not report feeling so pressured (or = 3.5). respondents who believed their friends would make fun of them if they decided not to have sexual intercourse with anyone at this stage in their life were more likely to have engaged in sexual intercourse than those respondents who believed their friends would not make fun of them if they decided not to have sexual intercourse (or = 2.2). results from this study demonstrated no association between parent-child communication and condom use or sexual behavior, self-efficacy for condom use, and perceived risk for contracting hiv. components from the theory of reasoned action (peer norms, intention to use condoms, and attitudes toward condoms) proved most useful for understanding condom use behavior among adolescents in belize.

The present study has important implications for hiv risk-reduction programs in belize, especially for the design and development of school-based hiv education and prevention programs that incorporate peers for promoting abstinence and safer sexual behavior.