Let’s talk about safer sex: an analysis to inform a safer sex intervention using the Theory of Planned Behaviour (TPB)

Author: Rowaida Sleem

Sleem, Rowaida, 2021 Let’s talk about safer sex: an analysis to inform a safer sex intervention using the Theory of Planned Behaviour (TPB), Flinders University, College of Education, Psychology and Social Work

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This study used the TPB as a theoretical framework to investigate safer sex practices of young people in SA. In addition to the attitudes, subjective norms, and perceived behavioural control constructs postulated in the TPB, other possible antecedents (e.g. alcohol consumption, and partner’s expectations) and background factors (e.g. age, parent/carer communication, religiosity, sexual status, and sex education) were identified through a review of the literature as possible predictors of intentions to safer sex behaviour. Based on these factors, a Safer Sex Use Extended TPB Model (SSUEM) was hypothesised.

A safer sex questionnaire was developed following Francis et al.’s (2004) recommendations. However, prior to conducting the main study, a pilot study was conducted to assess the designed survey instrument. The safer sex questionnaire was piloted with 84 University students. As a result, the original safer sex questionnaire required modification. Only the perceived behavioural control items, the demographic and the sexual health questions were used in the main study.

It was essential to re-visit the literature and identify another safer sex instrument based on the pilot results. Hence, the “Sexual Risk Scale” (SRS), a valid and reliable instrument developed by DeHart and Birkimer (1997), was identified as a suitable instrument to be used in the main study. The SRS instrument was used to test safer sex attitudes, subjective norms, partner’s expectations, safer sex intentions and the proposed SSUEM model. The main questionnaire was designed in three sections. The first and third sections included demographic and sexual health questions, while section 2 presented the SRS instrument and the perceived behavioural control items derived from the pilot study.

The main study data were collected through an online survey of 911 male and female young people aged 18–24 years who had finished their high school studies and were living in South Australia. Statistical Package for the Social Sciences (IBM-SPSS) version 27 was used to run descriptive and inferential statistics for sections 1 and 3 of the questionnaire. A Structural Equation Modeling (SEM) using Mplus was the primary data analysis procedure used to test the relationships between the identified factors of the SSUEM.

The findings suggest that safer sex attitudes, subjective norms, and perceived control are essential antecedents of safer sex intentions. These factors should be added to any intervention aiming to promote safer sex use among South Australians, especially young adult women. The findings suggest that the additional possible antecedents, parent/carer–teenage communication and sexual status, should also be added to any potential future intervention. In other words, safer sex attitudes; what friends think about safer sex; self-efficacy and control to perceive safer sex use; frequent parent/carer–teenage safer sex communication; and sexual status should also form the basis of a possible safer sex intervention. Future interventions can also build on the study findings to strengthen the relationship between schools and parents.

Keywords: safer sex, South Australian, STIs, unplanned pregnancy, condom use, dental dam, Theory of Planned Behaviour (TPB), parent/carer-teenage sexual communication, sex education, religiosity, sexual status, partner's expectations

Subject: Education thesis

Thesis type: Professional Doctorate
Completed: 2021
School: College of Education, Psychology and Social Work
Supervisor: Dr Grace Skrzypiec