Self-efficacy, decisional balance and stages of change for condom use among women at risk for HIV infection

Theory-based models of HIV prevention need to be tested using appropriate measures with populations at high risk. Data from interviews with 4036 women recruited from facilities and randomly sampled from high-risk communities were used to examine the mediating variables specified by the Transtheoretical Model (TM). The analysis aimed to test the reliability of brief self-efficacy and decisional balance measures, assess the relationships of these measures to stages of change for condom and contraceptive use, and examine the extent to which these findings are consistent for women interviewed in different settings. The results indicated that the scales measuring self-efficacy and advantages (pros) of the behaviors were moderately to highly reliable, while those measuring disadvantages (cons) were much less reliable. Results were similar for women recruited from community and from facility settings. Possible explanations for the low reliabilities for cons were examined. Significant differences in mean scores by stage of change were found for all measures of self-efficacy, pros and cons. These findings are consistent with patterns predicted by TM.