A structural model of HIV risk-taking intentions in Barbados

Introduction: The purpose of the study was to provide a comprehensive explanation of human immunodeficiency virus (HIV) (sexual) risk-taking intentions in Barbados using an extended model derived from the theory of planned behaviour (TPB) using structural equation modelling (SEM). The study extends this model by including two other factors essential for the prediction of an individual's intention to engage in unsafe sexual behaviours: knowledge about HIV/acquired immunodeficiency syndrome (AIDS) and perceived risk of or susceptibility to HIV infection. Material and methods: A structured questionnaire was used as the main data collection tool. The main constructs were: HIV Risk-taking Intentions, Attitudes, Subjective Norms, Perceived Behavioural Control, Knowledge of HIV/AIDS, and Perceived Risk. Three models were tested: SEM; a direct effects model; and the traditional TPB model. Results: The traditional TPB model performed best. Attitudes and perceived behavioural control were significant predictors of HIV risk-taking intentions; knowledge of HIV/AIDS and perceived risk of HIV infection had no influence. Conclusions: Behavioural change interventions should focus on changing attitudes towards sex and sexual behaviours among individuals since attitudes are important determinants of intentions. In terms of perceived behavioural control, efforts should be made to identify those persons who find it difficult to control their sexual behaviours. Enhancing these individuals' self-efficacy beliefs and confidence about condom use and other safe sex practices would curb intentions to engage in risky sexual practices as well as actual behaviours.