Online Program

Information-Motivation-Behavioral Skills model revisited: A network-perspective structural equation model within a public sexually transmitted infection clinic sample of hazardous alcohol users

Monday, November 2, 2015

Steven A. John, MPH, Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI
Jennifer L. Walsh, PhD, Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI
Lance S. Weinhardt, PhD, Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI
Background: The Information-Motivation-Behavioral Skills (IMB) model is useful for understanding sexual risk behavior. However, the IMB model has not been tested with hazardously-drinking sexually transmitted infection (STI) clinic patients, a subpopulation at greater HIV risk, or with a network-perspective sexual risk behavior outcome which considers both primary and non-primary partners.

Methods: Participants (N=569) were patients at a Midwestern public STI clinic who screened positive for hazardous drinking and risky sexual behavior. Survey items assessed HIV knowledge (information); social norms, attitudes, and intentions (motivation); and self-efficacy (behavioral skills). Sexual risk behavior (SRB) was operationalized as a latent variable with three indicators: 1) number of sexual partners, 2) number of unprotected sex occasions with primary partner, and 3) number of unprotected sex occasions with non-primary partner(s).

Results: Preliminary analyses suggested SRB was best operationalized as a latent variable with two indicators, while unprotected sex with primary partners should be considered separately. In a structural model with good fit, the IMB model was generally supported. Specifically, behavioral skills predicted less SRB (β=-0.27, p<0.01), fully mediated the association of information with SRB (βindirect=0.21, p<0.01), and partially mediated the association of motivation with SRB (βdirect=-0.18, p<0.05; βindirect=0.49, p<0.01). Contrary to expectations, behavioral skills predicted more unprotected sex with primary partners (β=0.17, p<0.01).

Conclusions: Findings suggest the IMB model functions differently for non-primary and multiple partners compared to primary partners in STI clinic patients with hazardous alcohol use. Intervention strategies based on different theoretical models may be needed to address risk behavior with primary partners.

Learning Areas:

Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Differentiate predictors of sexual risk behavior with non-primary and multiple sexual partners as compared to sexual risk behavior with primary sexual partners.

Keyword(s): Sexual Risk Behavior, Alcohol Use

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have years of experience in the realm of HIV. I was responsible for: 1) analysis and interpretation of the data and 2) drafting and final approval of the submitted abstract. Drs. Walsh and Weinhardt are Principal Investigators on multiple federally funded grants focusing on HIV prevention, and both provided mentorship, expertise, and approval of the submitted abstract. I have scientific interests in health behavior theory and multidisciplinary strategies of HIV and STI prevention.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3364.0: HIV and Substance Use