Predicting and explaining ‘at-risk’ online older women’s condom use intentions using an extended two-component TPB

Abstract

Background: UK sexual health surveillance data shows a recent rise in sexually transmitted infections [STIs] among women in the 45+ age group. However, current government policies and services that aim to reduce STIs are not typically tailored for the specific needs of this population. Further, the existing evidence base of condom use interventions for older women is restricted to one study from the USA. Aims: Using an extended two-component TPB, the aims of this study were to: (1) determine the significant independent predictors of ‘at-risk’ online older women’s condom use intentions; and (2) identify the key beliefs underlying the significant independent TPB predictors. Methods: A cross-sectional online survey was employed. 109 UK-based sexually active single women that were 45+ years and looking for a new sexual partner(s) were recruited through Facebook adverts. Participants completed measures of direct and belief-based (established via an elicitation study) two-component TPB constructs, anticipated regret, moral norm, self-identity, future time perspective, and past behaviour. A three-step hierarchical regression analysis was conducted for the first aim, while correlational analyses were undertaken for the second aim. Findings: The extended two-component TPB accounted for 78% of the variance in condom use intention. Experiential attitude, injunctive norm, perceived behavioural control - capacity, anticipated regret, and self-identity emerged as significant independent predictors. A total of seven key beliefs (one behavioural, one normative, and five control) were identified. Discussion: This study addresses a gap in the literature and provides guidance for the development of condom use interventions for ‘at-risk’ online older women.