Correlates of Condom Use Stages of Change among College Students in Taiwan

Background: Only 12-25% of sexually active Taiwanese college students use condoms consistently while 60% report having more than two sexual partners. This study explored the reason for condom non-use and the factors affecting transtheoretical model (TTM) stages of change for regular condom use among college students in Taiwan.

Methods: A descriptive, cross-sectional design was used to collect data from 996 college students from two universities in Taiwan. Structured self-report questionnaires included demographic information, condom use, HIV/AIDS knowledge, and self-efficacy in using condoms. Data were analyzed descriptively and with multiple logistic regression.

Results: Common reasons for not using condoms were trust in partner (21.30%), partner dislike for condoms (19.49%), and perception of low risk (18.77%). Participants in action or maintenance stages were (a) 43.4 % (95% CI 0.225-0.823) less likely to show high HIV/AIDS knowledge score, (b) 4.08 times (95% CI 1.949-8.523) more likely to present high self-efficacy, and (c) 2.24 times (95% CI 1.129-4.460) more likely to be more religious than those in contemplation or preparation.

Conclusions: This study reveals that preventive steps targeted at young adults should address concerns related to condom use such as trust in partners and appetites for unprotected sex. The perceptions of disliking sex with condoms and of low-risk situations should be addressed by public health nurses, including a discussion of techniques that may increase the satisfaction levels and with a specific evidence-based definition of safe sex. Increasing confidence for people in the earlier TTM stages may lead to more consistent practice of condom use.