Cognitive factors associated with condom use intentions in young African American women

Background Young African American women (YAAWs) experience disproportionately high rates of sexually transmitted infections (STIs), yet condom use remains inconsistent. Guided by the Theory of Planned Behavior (TPB), this study investigates cognitive and gendered predictors of condom use intentions and examines the influence of prior STI history on key TPB constructs. Methods We conducted a secondary cross-sectional analysis of baseline data from a culturally tailored, community-based STI/HIV prevention program in Detroit, Michigan. Participants (N = 196; ages 14–19) completed validated subscales assessing attitudes toward condoms, subjective norms, perceived behavioral control, masculine norms, and intentions to use condoms. Statistical analyses included Mann-Whitney U tests, multiple linear regression, and path analysis. Results The mean intention score for condom use was (M = 1.49, SD = 1.00), with attitudes toward condoms emerging as the strongest predictor of intention (p < 0.001). Subjective norms and behavioral control approached significance. Approximately 27% of participants reported a prior STI diagnosis. Participants with a history of STIs reported significantly less favorable condom attitudes (p = 0.015) and lower perceived social support for condom use (p = 0.025). Masculine norms were not significantly associated with condom use intentions. The TPB model explained 7.9%–8.3% of the variance in intention. Conclusion Condom-related attitudes and perceived norms play a central role in shaping condom use intentions among young African American women, particularly among those with a history of STIs. These findings suggest the need for culturally grounded interventions that target individual beliefs and normative influences to enhance condom use. Strengthening cognitive determinants may help reduce STI transmission risk and promote sexual health equity among high-risk adolescents.