Beliefs underlying chlamydia risk appraisals: the relationship with young adults' intentions to use condoms

Risk appraisals are identified by many theories of health behaviour as primary motivators of intention and action. However, limited evidence is available on the beliefs underlying risk appraisals. The nature of these beliefs must be understood in order to optimally modify risk appraisals in ways that motivate positive behaviour change. This study uses Cameron's illness risk representations framework to examine the extent to which beliefs about chlamydia predict risk appraisals and intentions to use condoms with casual sexual partners. A cross-sectional design was used. N = 921 secondary school and university students aged between 16 and 24 years completed the assessment of illness risk representations which includes measures of illness risk representation components namely identity, cause, timeline, consequences and control. As hypothesised, appraisals of the likelihood of chlamydia infection were positively associated with beliefs that symptoms of infection were present (identity), that exposure to chlamydia had occurred (cause) and that chlamydia affected young people (timeline). Severity appraisals were positively associated with beliefs that chlamydia would lead to pain, psychosocial and fertility consequences (all consequences scales). Contrary to hypotheses, severity appraisals were positively associated with beliefs that infection could be prevented (control over prevention) and cured (control over cure), and not associated with the belief that infection could be treated (control over treatment). Intentions to use condoms with casual sexual partners were predicted by beliefs about control over prevention. In conclusion, Cameron's framework appears to be useful for examining the content of risk appraisals and isolating beliefs to be targeted through health promotion interventions. The findings have provided new evidence about the basis for young adults' appraisals of the risk of chlamydia infection. They point to ways in which intentions to use condoms with casual sexual partners could be increased, through for example, developing skills around how to initiate condom use.