This article was downloaded by: [The UC Irvine Libraries]

On: 15 December 2014, At: 22:24

Publisher: Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered
office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

AIDS Care: Psychological and Socio-

medical Aspects of AIDS/HIV
Publication details, including instructions for authors and
subscription information:
http://www.tandfonline.com/loi/caic20

Study of the effect of information,

motivation and behavioural skills (IMB)
intervention in changing AIDS risk
behaviour in female university students
a
S. Singh
a
University of Delhi
Published online: 27 May 2010.

To cite this article: S. Singh (2003) Study of the effect of information, motivation and behavioural
skills (IMB) intervention in changing AIDS risk behaviour in female university students, AIDS Care:
Psychological and Socio-medical Aspects of AIDS/HIV, 15:1, 71-76, DOI: 10.1080/095401202100039770

To link to this article: http://dx.doi.org/10.1080/095401202100039770

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all the information (the
“Content”) contained in the publications on our platform. However, Taylor & Francis,
our agents, and our licensors make no representations or warranties whatsoever as to
the accuracy, completeness, or suitability for any purpose of the Content. Any opinions
and views expressed in this publication are the opinions and views of the authors,
and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content
should not be relied upon and should be independently verified with primary sources
of information. Taylor and Francis shall not be liable for any losses, actions, claims,
proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or
howsoever caused arising directly or indirectly in connection with, in relation to or arising
out of the use of the Content.

This article may be used for research, teaching, and private study purposes. Any
substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing,
systematic supply, or distribution in any form to anyone is expressly forbidden. Terms &
Conditions of access and use can be found at http://www.tandfonline.com/page/terms-
and-conditions
 AIDS CARE (2003), VOL. 15, NO. 1, pp. 71
/76

Study of the effect of information,

motivation and behavioural skills (IMB)
intervention in changing AIDS risk
behaviour in female university students

S. SINGH
Downloaded by [The UC Irvine Libraries] at 22:24 15 December 2014

University of Delhi, India

Abstract This study has perhaps for the first time in the Indian context made an attempt to use a
psychosocial model for a HIV/AIDS intervention programme. In line with the same, the main
objective of the research was to study the effect of the information, motivation and behavioural skills
(IMB) model-based intervention on a group of female college/university students. Purposive sampling
was used to select 200 participants; pre-testing of these participants revealed that they did not have
adequate information on issues related to HIV transmission and prevention. Further, neither were they
motivated nor possessed appropriate behavioural skills to engage in HIV preventive behaviours.
Following this, 100 participants were assigned to the experimental group and the remaining 100 to the
control group. Post-testing showed a significant increase in the level of information, motivation and
behavioural skills of the experimental group participants who underwent the three-session intervention
programme as compared to the control group participants.

Introduction
Young women today have the fastest growing incidence of HIV infection. Some of the reasons
advanced for this include biological make-up, power imbalances, social and economic
dependence and ignorance about HIV/AIDS and sexuality issues. In the Indian context, the
age old societal norms make young girls believe that engaging in discussion of safer sex issues
is a male prerogative putting them at a disadvantage in their personal and sexual relationships.
Further, there is a general tendency to delude oneself that young girls are above contracting
HIV as they come from ‘good families’. One could therefore say that due to their vulnerability
there is an urgent need for an intervention to facilitate AIDS risk reduction (ARR) behaviour.
Thus the present research has devised an intervention programme based on the information,
motivation and behavioural skills (IMB) model developed by Fisher and Fisher (1992) to
ascertain if the same would facilitate ARR behaviour.
According to the IMB model, there are three crucial fundamental determinants of AIDS
preventive behaviour namely information, motivation and behavioural skills. To be able to
engage in AIDS preventive behaviour, a person must possess relevant information regarding

Address for correspondence: Dr Shalini Singh, 2515 K Street, #203, NW, Washington, DC 20037, USA. Tel:
/1 202 248 2501. E-mail: shals239@rediffmail.com

ISSN 0954-0121 print/ISSN 1360-0451 online/03/010071-6 # Taylor & Francis Ltd

DOI: 10.1080/095401202100039770
 72 S. SINGH

HIV/AIDS transmission and prevention, as well as be highly motivated to initiate and

maintain ARR behaviour. Motivation to engage in ARR is based on the Theory of Reasoned
Action (Ajzen & Fishbein, 1980), according to which behavioural intention to engage in ARR
behaviour would be influenced by personal and social motivation. In addition to possessing
risk-reduction information and being motivated, an individual requires behavioural skills as a
final prerequisite for being able and to engage in AIDS preventive behaviour. These skills
would include the ability to seek and update relevant information regarding HIV/AIDS, to
communicate and negotiate for safer sex, exit situations where safer sex is unlikely and so on.
Thus, ARR behaviour is a function of being adequately informed about HIV/AIDS, being
motivated to engage in preventive behaviours and possessing behavioural skills for performing
the specific acts involved in prevention.
Downloaded by [The UC Irvine Libraries] at 22:24 15 December 2014

Methods
The main objective of the present research was to study the effect of the IMB intervention in
changing AIDS risk behaviour in a group of female college/university students. The research
design used was ‘before and after’; a total of 200 female college/university students constituted
the sample for the study. While selecting the sample the following was kept in mind:

. The participants were women, single, undergraduate/postgraduate students, between

the ages of 18
/22.
. They had never undergone a HIV/AIDS education programme.
. Of these, those who volunteered to participate in the three sessions of the intervention
programme constituted the experimental group (n/100) and the others were part of
the control group (n/100).

Procedure
To carry out the research three specific steps were undertaken, as follows. First, to ascertain
the existing level of information, motivation and behaviour skills elicitation research was
carried out, wherein all the 200 participants completed the measure of AIDS Prevention
Information, Motivation and Behavioral Skills questionnaire, developed by Misovich et al .
(1998) and the responses given by the participants at this point of time constituted the pre-
test scores.
Second, based on the findings of the elicitation phase, the experimental group
participants (n/100) experienced the intervention programme of three sessions to remedy
the specific deficits in risk reduction information, motivation and behavioural skills. Finally,
evaluation was carried out one month after completion of the intervention programme and
post-test scores were obtained from both the experimental and control group participants.

Intervention programme
The intervention comprised of three sessions. One session per week was held with the same
group of participants, lasting for a total of three weeks. Each of these sessions is discussed
below.

Session 1: Information component. The objective of this session was to reduce the gaps in
information regarding HIV/AIDS transmission and prevention. It may be pertinent to
 IMB INTERVENTION IN INDIA 73

mention that the component of information consists of three specific aspects of awareness,
namely INFO 1, 2 and 3. INFO 1 focuses on issues related to HIV transmission and
prevention, INFO 2 deals with information related to incidence, prevalence and vulnerability
to HIV amongst young adults and INFO 3 deals with HIV/AIDS information heuristics. The
tools used for this purpose included a lecture and slide show on various issues regarding HIV/
AIDS transmission and prevention. Further, misconceptions associated with casual contagion
and safer sex practices were addressed and time was set aside for discussion and clarification.
At the close of the session photocopies of a booklet containing basic information regarding
HIV/AIDS was given to the participants.

Session 2: Motivation component. In the second session, which aimed at modifying personal
attitudes and social norms so as to facilitate AIDS preventive behaviour, two video films were
screened. Video one, ‘Zindagi Umeed ke Saaye Main’ (Life in the shadows of hope, NACO,
Downloaded by [The UC Irvine Libraries] at 22:24 15 December 2014

1997), traces dilemma, emotional upheaval and strong comeback of the 23-year-old HIV-
positive protagonist. Video two, ‘Unmasking AIDS’ (International Planned Parenthood
Federation, 1994), centres on a young girl and her friends who challenge unfavourable
personal attitudes and social norms that hinder preventive practices. Both the video films help
focus on the fact that both men and women may have worries about HIV infection and that an
honest discussion can lead to changes in the negative attitudes and consequent behaviour.
The session concluded with a discussion on the issues that were brought to light bye the two
videos.

Session 3: Behavioural skills component. The objective of the session was to teach participants to
perform skilfully and effectively the steps involved in the AIDS preventive behaviour
sequence. Particular attention was paid to (1) information seeking, editing and updating,
(2) setting the limits in personal AIDS prevention agenda, (3) discussing and negotiating
about safer sex, and (4) public prevention acts.
The session included a discussion regarding the relevance of safer sex issues in the
context of HIV, followed by a condom demonstration by the researcher and then each
participant practised how to use a condom. Likewise, safer sex practices for oral and anal sex
were also discussed and demonstrated. The participants also engaged in role playing of
situations which covered various aspects of AIDS preventive behaviour such as limit setting in
relationships, negotiating for use of condoms and so on. At the end of each role play the
participants provided feedback on (1) whether the protagonists had adequately demonstrated
the central theme of the roles that they play; (2) whether the techniques used for discussing
and negotiating were adequate; and (3) in what other ways could the situation have been
handled.
After a month of the last session, post-test was carried out.

Results
The data obtained at the pre- and post-intervention was analyzed using mean, standard
deviation and ANCOVA. The results are presented in Table 1.
From Table 1 the following inferences may be drawn:

(1) The intervention had a significant impact on the knowledge base, increasing the
overall HIV/AIDS information scores (F /398.32) from the pre- to post-test
significantly, thereby indicating that the group that underwent the intervention
 74 S. SINGH

Table 1. Mean, standard deviation and F-values of ANCOVA for information,

motivation and behavioural skills

Experimental group (n /100) Control group (n /100)

Mean SD Mean SD F -value
INFO I
Pre-test 24.51 4.04 24.60 3.84 364.12
Post-test 32.14 1.07 24.46 4.46

INFO 2
Pre-test 2.79 1.04 2.79 0.99 82.42
Post-test 3.87 402 2.79 870

INFO 3
Pre-test 6.64 1.93 6.33 2.31 143.6
Post-test 8.72 .552 5.91 2.39
Downloaded by [The UC Irvine Libraries] at 22:24 15 December 2014

Information (total)
Pre-test 33.87 5.90 33.68 5.39 398.32
Post-test 44.57 1.51 33.40 6.14

Personal motivation
Pre-test 62.85 12.17 61.25 14.15 105.02
Post-test 42.30 10.20 61.25 14.50

Social motivation
Pre-test 22.44 6.94 24.22 10.04 124.91 
Post-test 15.52 4.95 24.25 8.74

Behavioural intention
Pre-test 23.45 6.98 22.80 8.43 136.72
Post-test 13.52 4.74 22.61 8.35

Motivation (total)
Pre-test 108.74 19.21 108.27 28.20 174.49
Post-test 71.43 14.26 107.24 26.66

Perceived difficulty
Pre-test 35.47 7.8 42.16 12.4 65.92
Post-test 45.66 8.25 42.93 11.0

Perceived effectiveness
Pre-test 62.68 10.72 59.56 14.06 134.96
Post-test 36.31 9.55 58.20 12.60

improved significantly on their knowledge base regarding various aspects of HIV/

AIDS as compared to the group that did not.
(2) Further, the level of motivation, including personal and social motivation and the
behavioural intention to engage in ARR behaviour (F /174.49) of the experi-
mental group participants as compared to the control group increased significantly
following the intervention.
(3) With regard to behavioural skills, on the sub-dimension of perceived difficulty
(which refers to how easy or difficult it is for them to engage in safer sex behaviours)
one finds that the experimental group after the intervention reported reduced
perceived difficulty to engage in ARR (F /65.92), unlike the control group
participants. On the second sub-dimension of behavioural skills, perceived effec-
tiveness (which refers to an individual’s ability to be able to effectively engage in
 IMB INTERVENTION IN INDIA 75

ARR behaviour) had significantly improved following the intervention with the
experimental group participants (F /134.96). In other words, the experimental
group reported greater efficacy in engaging in ARR behaviour as compared to the
control group.

Discussion
As is evident after undergoing the IMB intervention, the participants as compared to their
counterparts in the control group showed a significant increase in their level of awareness
regarding HIV/AIDS. Similar findings have been reported in research studies covering
heterosexual university students using the IMB-based intervention (Fisher et al ., 1996).
Likewise, prevention programme for gay/bisexual men (Kelly & St. Lawrence, 1990; Kelly et
al ., 1989, 1990) and adolescents (Jemmott et al ., 1992a; Rotheram-Borus et al ., 1991), based
on the social cognitive theory, revealed that experimental group participants as compared to
Downloaded by [The UC Irvine Libraries] at 22:24 15 December 2014

the control group exhibited increases in their level of awareness regarding HIV/AIDS.
Often HIV/AIDS education focuses primarily on providing information and ignoring
other aspects of behaviour change. Researchers now suggest that information is a necessary
but often not a sufficient condition for AIDS risk behaviour change. In other words, being
informed about HIV/AIDS on its own does not translate in to behaviour change (DiClemente
et al ., 1990; Norris & Ford, 1991). Further, information may have more impact when the
behaviour involved is uncomplicated, like avoiding or abstaining from sexual contact as
opposed to behaviours such as buying, negotiating about and consistently using condoms.
More recently efforts have been made to incorporate other variables which play a crucial role
in reducing ARR behaviours. In line with this, the IMB model suggests that unless there is an
increase in the level of motivation to practise safer sex, improvements in the knowledge base
may not yield the desired results.
At pre-test, the level of motivation (social and personal) and the intent to engage in ARR
behaviour were found to be moderate in the female college/university students. Following the
intervention, the experimental group reported a higher motivation to engage in ARR
behaviour as compared to the control group, which continued to report only moderate
motivation. Similar findings on motivation to engage in ARR behaviour after the IMB
intervention have been observed in a group of heterosexual university students and gay men
(Fisher, et al ., 1996), as well school students (Klepp et al ., 1994; Stanton et al ., 1998).
Studies such as those of Valdiserri et al . (1989), Leviton et al . (1990) and Abramson et al .
(1989) have all demonstrated that following intervention the personal attitudes of the
participants towards engaging in AIDS preventive behaviour improved significantly.
In addition to being adequately informed and motivated, an individual also needs to
possess certain skills in their repertoire to be able to engage effectively in AIDS preventive
behaviours. In this study the participants were found to be lacking in some of the important
behavioural skills such as the ability to seek and update HIV/AIDS related information,
engage in pre-sex negotiation, buy condoms, keep them handy and so on. Likewise, on the
sub-dimension of perceived difficulty, one finds that the participants at the pre-test were of the
view that it would be neither difficult nor easy for them to engage in preventive behaviours,
but after the intervention the perceived difficulty reduced significantly. Perceived effectiveness
also showed a similar trend in the sense that participants reported a higher efficacy to engage
in preventive behaviours.
These findings appear to be in line with studies which have emphasized the acquisition of
requisite behavioural skills to initiate and maintain safer sex practices in adolescents (Jemmott
et al ., 1992b) and women (Gomez et al ., 1999).
 76 S. SINGH

To conclude, the findings in the present research showed that information, motivation
and behaviour skills essentially contribute to AIDS preventive behaviour, hence these
components need to be incorporated in specific ways in various HIV/AIDS prevention
programmes. Further, if the intervention has to be maximally effective it needs to be based on
behaviourally relevant information, motivation and behavioural skills required by the group at
which the intervention is targeted.

References
ABRAMSON, P.R., SEKLER, J.C., BERK, R. & CLOUD, M.Y. (1989). An evaluation of an undergraduate course on AIDS.
Evaluation Review, 13 , 516
/532.
AJZEN, I. & FISHBEIN, M. (1980). Understanding attitudes and predicting social behavior . Engelwood Cliffs, NJ: Prentice
Hall.
Downloaded by [The UC Irvine Libraries] at 22:24 15 December 2014

DICLEMENTE, R.J., FORREST, K.A. & MICKLER, S. (1990). College students’ knowledge and attitudes about AIDS
and changes in HIV preventive behaviors. AIDS Education and Prevention , 2 , 201
/212.
FISHER, J.D. & FISHER, W.A. (1992). Changing AIDS risk behavior. Psychological Bulletin , 111 , 455
/474.
FISHER, J.D., FISHER, W.A., MISOVICH, S.J., WILLIAMS, S.S. & MALLOY, T.E. (1996). Changing AIDS risk behavior:
effects of an intervention emphasizing AIDS risk reduction Information, Motivation, and Behavioral skills in a
college student population. Health Psychology, 15 , 114
/123.
GOMEZ, C.A., HERHANDEZ, M. & FAIGELES, B. (1999). Sex in the new world: an empowerment model for HIV
prevention in Latino immigrant women. Health Education Behavior , 26 , 200
/212.
INTERNATIONAL PLANNED PARENTHOOD FEDERATION (1994). Unmasking AIDS. London: IPPF.
JEMMOTT, J.B., JEMMOTT, L.S. & FONG, G.T. (1992a). Reductions in HIV risk-associated sexual behaviors among
Black male adolescents: effects of an AIDS prevention intervention. American Journal of Public Health , 82 , 372
/
377.
JEMMOTT, J.B., JEMMOTT, L.S., SPEARS, H., HEWITT, N. & CRUZ-COLLINS, M. (1992b). Self-efficacy, hedonistic
expectancies and condom use intentions among inner-city Black adolescent women: a social-cognitive approach to
AIDS risk behavior. Journal of Adolescent Health , 13 , 512
/519.
KELLY, J.A. & ST. LAWRENCE, J.S. (1990). The impact of community based groups to help persons reduce behaviours
that create risk for HIV infection. AIDS Care , 2 , 25
/26.
KELLY, J.A., ST. LAWRENCE, J.S., BETTS, R.A., BRASFIELD, T.L. & HOOD, H.V. (1990). A skills training group
intervention model to assist persons in reducing risk behaviors for HIV infection. AIDS Education and Prevention , 2 ,
24
/35.
KELLY, J.A., ST. LAWRENCE, J.S., HOOD, H.V. & BRASFIELD, T.L. (1989). Behavioral intervention to reduce AIDS risk
activities. Journal of Clinical and Consulting Psychology, 57 , 60
/67.
KLEPP, K.I., NDEKI, S.S., SEHA, A.M., HANNAN, P., LYIMO, B.A., MSUYA, M.H., IREMA, M.N. & SCHRINER, A.
(1994). AIDS education for primary school children in Tanzania: an evaluation study. AIDS , 8 , 1157
/1162.
LEVITON, L.C., VALDISERRI, R.O., LYTER, D.W., CALLAHAN, C.M., KINGSLEY, L.A., HUGGINS, J. & RINALDO, C.R.
(1990). Preventing HIV infection in gay and bisexual men: experimental evaluation of attitude change from two risk
reduction interventions. AIDS Education and Prevention , 2 , 95
/108.
MISOVICH, S.J., FISHER, W.A. & FISHER, J.D. (1998). A measure of AIDS prevention information, motivation and
behavioral skills. In: DAVIES, C.M., YARBES, W.H., BAUSERMAN, R., SCHEER, G. & DAVIS, S.L. (Eds), Handbook of
sexuality related measures . CA: Sage.
NACO (National AIDS Control Organization) (1997). Zindagi Umeed Ke Sayee Mein [Life in the Shadow of Hope].
New Delhi: NACO, Ministry of Health and Family Welfare.
NORRIS, A.E. & FORD, K. (1991). AIDS risk behaviors of minority youth living in Detroit. American Journal of
Preventive Medicine , 7 , 416
/421.
ROTHERAM-BORUS, M.J., KOOPMAN, C., HAIGNERE, C. & DAVIES, M. (1991). Reducing HIV sexual risk behaviors
among runaway adolescents. Journal of the American Medical Association , 266 , 1237
/1241.
STANTON, B.E., LI, X., KAHIHUTA, J., FITZGERALD, A.M., NEUMBO, S., KANDUMOMBE, G., RICARDO, I.B.,
GALBRAITH, J.S., TERRERI, N., GNEVARA, I., SHIPENA, H., STRIJDOM, J., CLEMENS, R. & ZIMBA, R.F. (1998).
Increased protected sex and abstinence among Namibian youth following a HIV risk reduction intervention: a
randomised longitudinal study. AIDS , 12 , 2473
/2480.
VALDISERRI, R.O., LYTER, D.W., KINGSLE, L.A., LEVITON, L., SCHOFIELD, J.W., HUGGINS, P., HO, M. & RINALDO,
C.R. (1989). AIDS prevention in homosexual and bisexual men. Results of a randomised trial: evaluating two risk
reduction interventions. AIDS , 3 , 21
/26.