Determinants of condom use among heterosexual young men and women in southeastern Ghana: a mediation analysis

ABSTRACT

Sexual risk behaviour among young people raises public health concerns in Ghana. This study aimed to determine the predictors of condom use among heterosexual young people in the eastern region of Ghana, using a health behaviour theory – the theory of planned behaviour (TPB). Participants completed a questionnaire battery assessing attitudes, subjective norms, perceived behavioural control, intentions and condom use behaviour. Structural equation modelling procedures were used to analyse the data. Attitudes towards condom use and perceived behavioural control over condom use were significantly positively associated with the intention to use condoms. Intention to use condoms predicted condom use behaviour. Moreover, intention to use condoms mediated the attitude–behaviour relationship, and the perceived control–behaviour relationship. These results highlight the importance of using behavioural beliefs, perceived control beliefs and behavioural intention as key variables in condom promotion programmes among in-school heterosexual youth in the eastern region of Ghana.

KEYWORDS:

• Adolescent sexual health
• sexual risk behaviour
• condoms
• structural equation model
• mediation analysis

Acknowledgment

This work was supported by the Graduate School of Arts and Social Sciences at Stellenbosch University in the form of a doctoral scholarship awarded to the corresponding author. The research reported on here emerged from the doctoral dissertation. Thus, opinions expressed and conclusions arrived at are those of the authors and are not to be attributed to the Graduate School or Stellenbosch University.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Enoch Teye-Kwadjo

Enoch Teye-Kwadjo (PhD) is a Lecturer in Health Psychology at the University of Ghana, Ghana. His research interests focus on health behaviour theory, adolescent sexual health, HIV, and condom use. Dr Teye-Kwadjo’s other research interests include psychometrics, structural equation modelling, qualitative and quantitative data analyses. He also conducts research on traffic risk perception and road traffic behaviour.

Ashraf Kagee

Ashraf Kagee (PhD, MPH) is a distinguished Professor of Health Psychology at Stellenbosch University, South Africa. His work is broadly located at the nexus of psychology and public health and is specifically focused on mental health among persons living with HIV and on psychological and structural factors influencing adherence to antiretroviral therapy (ART). Professor Kagee’s other research interests include stress and trauma, mental health and chronic illness, and evidence-based practice.

Hermann Swart

Hermann Swart (DPhil) is a Lecturer in Social Psychology at Stellenbosch University, South Africa. His research interests include diversity, intergroup contact, intergroup emotions, prejudice and stereotype reduction in post-conflict societies, and interpersonal friendships. He also specialises in longitudinal research and multivariate analyses using structural equation modelling.