Using protection motivation theory to predict condom usage and assess HIV health communication efficacy in Singapore.

The number of individuals infected with HIV/AIDS continues to rise in Asia. Condom use is considered to be the first line of defense against AIDS (UNAIDS, 2006). Using protection motivation theory (Rogers, 1983), this research aims to first understand the factors affecting condom usage intention among homosexual and heterosexual men in Singapore, and then to utilize those findings to assess the efficacy of HIV-directed health communications. We collected survey data from 484 men and analyzed the data using hierarchical regression and structural equation modeling. We found self-efficacy to be a significant predictor for both groups of men, together with perceived severity for homosexuals and response efficacy for heterosexuals. Next, we analyzed HIV-directed condom usage communication materials and found that the use of threat appeal themes is more common than themes promoting self-efficacy. Implications for health communications and policy are discussed.