Transtheoretical model and condom use in HIV-positive youths.

The purpose of the study is to test constructs of the Transtheoretical Model for predicting unprotected intercourse in HIV-positive youths (ages 16-25 years). Questionnaires and interviews about sexual behavior, stage of change, self-efficacy, substance use, emotional distress, and social support were obtained from 60 HIV-positive youths. Path analysis, with standard errors determined by methods appropriate to small samples, suggested that self-efficacy completely mediated the relationship between stage of change and unprotected intercourse acts. Social support specific to reducing risk was associated with increased self-efficacy. Emotional distress and low general social support were not associated with decreased condom use. The path between substance use and decreased condom use approached significance. Results highlight the potential of prevention interventions that simultaneously boost self-efficacy and social support specific to practicing safer sex as well as those that reduce substance use.