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Processes of Change in the Adoption of Consistent Condom Use

Centers for Disease Control and Prevention, Atlanta, USA

Tracey Lockaby

University of South Florida School of Public Health, Tampa, USA

Linda Fogarty

Johns Hopkins School of Hygiene and Public Health, Baltimore, USA

Abigail Cohen

Family Planning Council of Pennsylvania, Philadelphia, USA

David Cotton

Macro International, Inc., Atlanta, USA

Descriptions of reproductive and sexual behavior were obtained from interviews with a convenience sample of women at risk of HIV infection or transmission to assess whether the processes of change (POC) constructs from the Transtheoretical Model apply to women's explanations of condom behavior change. Participants were recruited from public housing, drug treatment centers, homeless shelters, and other sources. Interviews with 45 women were selected for analysis based on criteria of condom behavior change and narrative richness. In phase I, POC constructs were identified in women's statements regarding condom behavior change, using an a priori coding scheme. In phase II, text passages for each POC were examined for the range of topics addressed and the POC's perceived function in condom use adoption. Results show that each POC was identified at least once and that all respondents made statements that matched at least two POCs. Only 4 percent of 400 text segments did not fit a POC category. POC constructs appear to be integral components of the strategies women in this study used to progress toward consistent condom use with male partners. Interventions that promote condom use may be strengthened by using POC constructs as a basis for service delivery.

Key Words: condom use • processes of behavior change • qualitative content analysis, Transtheoretical Model • women

Journal of Health Psychology, Vol. 3, No. 3, 349-368 (1998)
DOI: 10.1177/135910539800300305


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