Stages of condom use and decisional balance among college students

Aims: To explore sexual behaviours and condom use and differences in specific items of perceived benefits and barriers to condoms using the Transtheoretical Model (TTM) stages among college students in southern Taiwan. Background: The TTM suggests that individuals in the action or maintenance stage exhibit higher levels of perceived benefits and lower levels of perceived barriers related to condom use than people in the precontemplation, contemplation or preparation stage. Methods: This was a descriptive, cross-sectional design with cluster sampling among college students from two universities in southern Taiwan. Participants completed self-administered questionnaires, including demographic data, Sexual History and Condom Use Scale and Condom Use Decisional Balance Scale. Results: Of the 279 participants, 57% were sexually active, of these only 11.9% used condoms consistently. Respondents in the TTM stage of action/maintenance perceived greater benefits in relation to feeling more responsible (P = 0.031) and protecting their partners as well as themselves (P = 0.028), and perceived more barriers in believing that using condom needs to rely on partner's cooperation (P = 0.046) than participants in precontemplation. Participants in precontemplation and contemplation perceived more barriers related to worry about making their partner angry if condoms were used than those in action/maintenance (P = 0.008). Conclusion: Low levels of condom use among Taiwanese college students remain a significant public health concern. HIV prevention programmes for college students in Taiwan may be enhanced if they incorporate readiness to change and perceived benefits and barriers. Future research should include a larger sample with diverse groups.