Intention to Have Sexual Intercourse without a Condom

1. Introduction Throughout the 1990s, the use of different contraceptive methods among young people increased progressively, with the male condom occupying a prominent position. Owing possibly to its being one of the most accessible, and the one which helps to prevent, with high levels of effectiveness, unwanted pregnancies and/or sexually transmitted diseases, which by the end of the 1980s had reached truly disconcerting levels in Spain. Nonetheless, in recent years, a number of studies have hightlighted a certain drop in the use of this method of contraception in the setting of sexual intercourse which may entail some type of risk (Conde 2004, CIMOP 2005, Real, Oliva, Suarez & Vazquez 2003). According to data for 2012 from the Spanish Ministry of Health, Social Services and Equality, it is in the 20 to 29 age group, very similar to the one used in this study, where the abortion rate is highest (37.79 per thousand). In recent years use of the so-called morning-after pill has mushroomed and our youngsters are starting to use it as a replacement for the condom, with all the health risks that practices of this type may entail, thus ignoring the condom's prophylactic function. In this regard, there has also been an increase in sexually transmitted diseases over recent years, affecting not only high-risk groups, but also broad sections of the population, such as young people (Lepe, Otero, Blanco, Aznar, & Vazquez 2008). It is precisely this tendency for young people to expose themselves to risks of this type that has led us to attempt to explain what it is that motivates them to perform behaviours of this type, which are being consolidated in an alarming way. Thus, there is a need to better understand the psychosocial factors that have a bearing on these behaviours with a view to being able to propose specific corrective measures to prevent them. In the research carried out on the use of condoms, different theoretical models have been applied, including the Health Belief Model (Becker 1974, Rosenstock 1974), the Self-Efficacy Model (Bandura 1977), to the Theory of Reasoned Action (Ajzen & Fishbein 1977, Fishbein 1980, Fishbein & Ajzen 1975) and/or the Theory of Planned Behaviour (Ajzen & Madden 1986, Ajzen 1991, 2002). The final one mentioned, the TPB, is one of the most widely used models for attempting to explain factors that have a bearing on intention, such as in the behaviour of using a condom (Albarracin, Johnson, Fishbein & Muellerleile 2001, Carmack & Lewis-Moss 2009, Groenenboom, Van Weert & van den Putte 2009, Protogerou, Flisher, Aaro & Matheus 2012, Protogerou, Flisher, Wild & Aaro 2013, Rijsdijk et al 2012, Sheeran & Taylor 1999). In accordance with the Theory of Planned Behaviour (TPB), the immediate determinant of behaviour is behavioural intention, which is in turn determined by attitude towards the behaviour, the subjective norm and perceived behavioural control. These three variables are based on behavioural, normative and control beliefs, respectively. Nonetheless, as the authors point out, there are factors which can limit the subjects' will to perform a determined behaviour. Accordingly, perceived control, along with intention, will also be considered an immediate determinant of the behaviour. Despite the TPB being one of most widely used theories for predicting a broad range of behaviours, according to a recent meta-analysis by McEachan, Conner, Taylor & Lawton (2011), the explanatory capacity of the TPB in intention to maintain generally healthy behaviour, such as condom use, has not been very high (43.3%), with relationships of moderate or little significance having been found between the different variables. Hence, from a number of different studies, an extension of the model has been proposed, by adding additional variables which may allow its explanatory power to be enhanced. In the context of condom use, a number of variables have been introduced such as self-efficacy (Beadnell, Wilsdon, Wells, Morison, Gillmore & Hoppe 2007), perceived risk (Cha, Kim & Patrick 2007), emotions (Caballero, Toro, Sanchez & Carrera 2009, Conner, Graham & Moore 1999, Perugini & Bagozzi 2001, Rivis, Sheeran & Armitage 2009), the moral norm (Conner, Smith & Mcmilla 2003, Godin, Conner & Sheeran 2005, Jellema, Abraham, Schaalma, Gebhardt & Empelen 2013), sexual arousal (Turchik & Gydyez 2012) and/or past conduct (Lugoe & Rise 1999). …