Predicting Condom Use Using the Information-Motivation-Behavioral Skills (IMB) Model: A Multivariate Latent Growth Curve Analysis

Background The Information-Motivation-Behavioral Skills (IMB) model often guides sexual risk reduction programs even though no studies have examined covariation in the theory's constructs in a dynamic fashion with longitudinal data. Purpose Using new developments in latent growth modeling, we explore how changes in information, motivation, and behavioral skills over 9 months relate to changes in condom use among STD clinic patients. Methods Participants (N=1281, 50% female, 66% African American) completed measures of IMB constructs at three time points. We used parallel process latent growth modeling to examine associations among intercepts and slopes of IMB constructs. Results Initial levels of motivation, behavioral skills, and condom use were all positively associated, with behavioral skills partially mediating associations between motivation and condom use. Changes over time in behavioral skills positively related to changes in condom use. Conclusions Results support the key role of behavioral skills in sexual risk reduction, suggesting these skills should be targeted in HIV prevention interventions. Keywords Condoms . HIV . IMB . Sexual risk behavior . STD Sexually transmitted diseases (STDs) are highly prevalent, with nearly 19 million new infections per year in the USA [1, 2]. HIV rates also remain high, with over 56,300 new infections a year [3], 84% of which result from sexual contact [4]. Patients at STD clinics are more likely than those from community samples to acquire multiple STDs [5] and to be infected with HIV [6]. Correct and consistent condom use provides one of the most effective strategies for preventing the spread of STDs, including HIV [7-9], making determining the predictors of condom use among at-risk populations a priority.