Modelling and modifying young heterosexuals' HIV-preventive behaviour; a review of theories, findings and educational implications.

Studies applying social cognitive frameworks such as the health belief model and the theory of reasoned action to HIV-prevention are reviewed. These models suggest that appropriate beliefs, attitudes, social norms, intentions and perceived self-efficacy are sufficient psychological conditions for safer sexual behaviour. Limitations inherent in these accounts are identified and additional factors which need to be incorporated in psychological models and health education programmes are highlighted. These include, the motivational complexity of sexual behaviour, the emotional and arousal states in which it is enacted, the difficulties of planning what is regarded as spontaneous interaction and contextual factors which can undermine HIV-preventive intentions. Health education interventions aimed at individual, group and community levels are examined in light of this theoretical review and action-focused, empowering interventions grounded in youth culture are recommended.