Correlates of Condom-use Self-efficacy on the EPPM-based Integrated Model among Chinese College Students

Objective To explore the predictors of condom-use self-efficacy in Chinese college students according to the extended parallel process model （EPPM）-based integrated model. Methods A total of 3,082 college students were anonymously surveyed through self-administered questionnaires in Guangzhou and Harbin, China. A structural equation model was applied to assess the integrated model. Results Among the participants, 2,387 （46.7%） were male, 2,586 （53.3%） were female, and the average age was 18.6 years. The final integrated model was acceptable. Apart from the direct effect （r = 0.23）, perceived severity had two indirect effects on condom-use self-efficacy through the attitude to HIV education （r = 0.40） and intention to engage in premarital sex （r = -0.16）, respectively. However, the perceived susceptibility mediated through the intention to engage in premarital sex （intent-to-premarital-sex） had a poor indirect impact on condom-use self-efficacy （total effect was -0.06）. Furthermore, attitude toward HIV health education （r = 0.49） and intent-to-premarital-sex （r = -0.32） had a strong direct effect on condom-use self-efficacy. In addition, male students perceived higher susceptibility, stronger intent-to-premarital-sex, and lower condom-use self-efficacy than female students. Conclusion The integrated model may be used to assess the determinants of condom-use self-efficacy among Chinese college students. Future research should focus on raising the severity perception, HIV-risk-reduction motivation, and the premarital abstinence intention among college students. Furthermore, considering the gender differences observed in the present survey, single-sex HIV education is required in school-based HIV/sex intervention.

A risk-based model for predicting the impact of using condoms on the spread of sexually transmitted infections

We create and analyze a mathematical model to understand the impact of condom-use and sexual behavior on the prevalence and spread of Sexually Transmitted Infections(STIs).STIs remain significant public health challenges globally with a high burden of some Sexually Transmitted Diseases(STDs)in both developed and undeveloped countries.Although condom-use is known to reduce the transmission of STIs,there are a few quantitative population-based studies on the protective role of condom-use in reducing the incidence of STIs.The number of concurrent partners is correlated with their risk of being infectious by an STI such as chlamydia,gonorrhea,or syphilis.We develop a Susceptible-Infectious-Susceptible(SIS)model that stratifies the population based on the number of concurrent partners.The model captures the multi-level heterogeneous mixing through a combination of biased(preferential)and random(proportional)mixing processes between individuals with distinct risk levels,and accounts for differences in condom-use in the low-and high-risk populations.We use sensitivity analysis to assess the relative impact of high-risk people using condom as a prophylactic intervention to reduce their chance of being infectious,or infecting others.The model predicts the STI prevalence as a function of the number of partners of an individual,and quantifies how this distribution of effective partners changes as a function of condom-use.Our results show that when the mixing is random,then increasing the condom-use in the high-risk population is more effective in reducing the prevalence than when many of the partners of high-risk people have high risk.The model quantifies how the risk of being infected increases for people who have more partners,and the need for high-risk people to consistently use condoms to reduce their risk of infection.