Attitudes, norms, and self-efficacy: a model of adolescents' HIV-related sexual risk behavior

Health Educ Q. Summer 1992;19(2):263-77. doi: 10.1177/109019819201900209.


Using data from a cross-sectional, statewide survey of 1,720 Texas ninth graders in 13 school districts, a model of psychosocial predictors of human immunodeficiency virus (HIV)-related sexual risk behavior was tested. Predictor variables in the model, based on variables from the Theory of Reasoned Action and Social Learning Theory, were attitudes, norms, self-efficacy, and behavioral intentions. Attitudes, norms, and self-efficacy predicted 36.4% of the variance in the intention to limit the number of sexual partners and the same variables plus intention predicted 24.6% of the variance in number of sexual partners in the past year. Attitudes, norms, and self-efficacy regarding condom use predicted 17.0% of the variance in condom use intentions; these variables plus intentions predicted 19.0% of the variance in condom use frequency. Attitudes, norms, and intentions were directly related to the number of sexual partners, while self-efficacy ad condom use intentions were directly related to frequency of condom use.

PIP: Despite fairly high knowledge among adolescents about HIV and AIDS, may continue to engage in risky sexual behavior. Supporting the notion that factual knowledge does not necessarily lead to behavioral change, a cross-sectional survey of Massachusetts adolescents found no difference in knowledge between condom users and nonusers. Little research, however, has been conducted on how to apply behavioral theory to get youths to reduce their level of risky behavior. Ajzen and Fishbein's Theory of Reasoned Action holds that intention is an immediate determinant of behavior; the notion of self-efficacy may be added to incorporate intent. A model is hypothesized based on a study to predict smoking behavior, which investigates individual decisions to have or not have sex, and the frequency of condom use. Psychosocial predictor variables of HIV-related sexual risk behavior are attitudes, norms, self-efficacy, and behavioral intentions, and were explored in cross-sectional statewide data from a survey of 1,720 Texas 9th graders over 13 school districts. Self-efficacy made a unique contribution to explaining intentions and behaviors, especially in the area of condom use. Attitudes, norms, and self-efficacy were related to behavioral intentions about deciding whether to have sex; attitudes and self-efficacy were related to condom use intentions; attitudes, norms, and intentions were related to number of sex partners; and self-efficacy and intentions were related to condom use frequency. Given the prevalence of risky sexual behavior found in this sample, broader based education is called for. School education should be provided, condoms made available, counseling offered, and mass media information campaigns implemented.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Adult
  • Attitude*
  • Contraceptive Devices, Male / statistics & numerical data
  • Cross-Sectional Studies
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / transmission*
  • Humans
  • Male
  • Models, Psychological*
  • Sexual Behavior*
  • United States / epidemiology