Psychosocial predictors of reported HIV-preventive behaviour change among adults in Bulawayo, Zimbabwe.

In order to reduce HIV transmission, improved understanding of factors that motivate safer sexual behaviour is needed. The Health Belief Model attempts to explain health-related behaviour, including HIV-preventive behaviour. The association of six elements of this model--AIDS knowledge, perceived susceptibility to HIV infection, perceived effectiveness of HIV-preventive measures, self-efficacy, barriers to behaviour change, accessibility of health care/advice and social support for safer sexual behaviour--to three indices of HIV-related behavioural risk reduction--reduced number of sexual partners, increased consistency of condom use and (among males only) reduced prostitute contact--was examined by self-report inventory among 202 men and 100 women in Bulawayo, Zimbabwe. Multiple logistic regression identified social support for behaviour change, followed by accessibility of health care/advice, as the most consistent predictors of risk reduction across sex and outcome measures. The remaining predictors were not consistently associated with behaviour change. It is concluded that AIDS campaigns must foster the perception that there is concerted normative support for HIV-related behaviour change and that community and small group, face-to-face AIDS education, which may have more impact on perceived social support than mass media campaigns, must be emphasised.