A Moderated Mediation Model to Explain Consistent Condom Use Intention Among Young Adults in South Africa

Abstract

Background Behavioral sustenance is one of the main outcomes of social marketing programs to address health issues, such as HIV and AIDS prevention. However, academic research into consistent condom use is interestingly sparse, particularly in South Africa, the country with the highest HIV-infected population in the world. Young adults are particularly vulnerable because they often engage in unprotected sex. Focus of the Article This study explores the factors driving consistent condom use intention with theoretical considerations in the expectation confirmation theory. The study investigates whether factors within the condom product category such as brand satisfaction and brand value enhance or weaken the effect of met/unmet brand expectations on consistent condom use intention of young adults. It further tests whether this potential enhanced or weakened effect significantly differs between male and female condom users. Research Questions Does dis/confirmation influence consistent condom use in the presence of brand satisfaction and brand value or not? Does gender moderate the mediations found in the expectation confirmation model? Importance to the Social Marketing Field From a theoretical perspective, the study expands the expectancy confirmation theory by focusing on the indirect effects of dis/confirmation on continuance intention. The study also tests the mediated moderating role of gender. Methods The study was descriptive in nature and a quantitative survey was used to obtain data from 724 young adults in South Africa. Quota sampling was applied to select respondents. Finally, the structural equation modelling technique was used to assess the measurement and structural models. Results Findings indicate that perceived brand value determines consistent condom use intention. The mediating role of perceived brand value on the relationship between dis/confirmation and consistent condom use intention was more pronounced among males compared to females. Dis/confirmation and perceived brand value were significant determinants of condom brand satisfaction. However, the influence of brand satisfaction on consistent condom use intention was not supported. Recommendations for Research or Practice The concept of consistent condom use should be integrated in the brand message. A segmented approach based on gender should be used by condom companies to promote their products to young adults. These companies should provide condoms that meet the expectations of male and female young adult consumers as two different market segments. Limitations Only one province was investigated in South Africa. Social desirability bias was not controlled.