BACKGROUND

While condom use has been extensively studied as a protective behavior, research directly focusing on condomless sexual intercourse (CSI) as a distinct and intentional risk behavior, particularly regarding gender differences, remains scarce.

METHODS

Building upon the Theory of Planned Behavior (TPB), this study addresses this gap by comparing TPB factors and individual TPB items regarding intentional CSI among cisgender heterosexual college varsity athletes in Taiwan ( = 1348).

RESULTS

High CSI intention was more prevalent among men (53.6 %) than women (31.7 %). Our expanded TPB framework identified five distinct TPB factors pertaining to attitudes, norms, and perceived control. Multivariate logistic regression analysis demonstrated that all five TPB factors were significantly associated with CSI intention among men, but only three among women. Notably, our factor analysis differentiated attitudes toward positive/negative outcomes of CSI and perceived control under facilitating/constraining conditions, revealing attitudes toward positive outcomes of CSI as the strongest driver of CSI intention among both men (AOR = 2.51-4.09) and women (AOR = 3.79-5.71). Further analysis of TPB items disclosed that men prioritized psychological pleasure (AOR = 2.18), whereas women exhibited a "partner-centered" tendency, emphasizing trust by sex partners (AOR = 3.43).

CONCLUSIONS

Overall, men exhibited more favorable views toward CSI than women, with gender differences evident in the differential associations of varying TPB factors and items with CSI intention. Future research could explore the development of these differential attitudes, norms, and perceived control concerning CSI. Given the modifiable nature of TPB variables, our study's insights can inform actionable strategies and targeted interventions tailored for young men and women.