Schematic presentation of the Protection Motivation Theory (PMT) and its seven subconstructs.

<p>PMT consists of seven constructs organized as two pathways (i.e. the threat appraisal pathway and the coping appraisal pathway) linking perceptions to behavior. The threat appraisal pathway consists of four constructs in two groups (severity and vulnerability, intrinsic rewards and extrinsic rewards). Coping appraisal pathway consists of three subconstructs in two groups (response efficacy and self-efficacy, response costs).</p

Protection Motivation Theory in Predicting Intention to Engage in Protective Behaviors against <i>Schistosomiasis</i> among Middle School Students in Rural China

<div><p>Background</p><p>Among millions of people who suffer from <i>schistosomiasis</i> in China, adolescents are at increased risk to be infected. However, <b>t</b>here is a lack of theory-guided behavioral prevention intervention programs to protect these adolescents. This study attempted to apply the Protection Motivation Theory (PMT) in predicting intentions to engage in protective behaviors against <i>schistosomiasis</i> infection.</p><p>Methods</p><p>The participants were selected using the stratified cluster sampling method. Survey data were collected using anonymous self-reported questionnaire. The advanced structural equation modeling (SEM) method was utilized to assess the complex relationship among <i>schistosomiasis</i> knowledge, previous risk exposure and protective measures in predicting intentions to engage in protective behavior through the PMT constructs.</p><p>Principal Findings</p><p>Approximately 70% of participants reported they were always aware of <i>schistosomiasis</i> before exposure to water with endemic <i>schistosomiasis</i>, 6% of the participants reported frequency of weekly or monthly prior exposure to snail-conditioned water. 74% of participants reported having always engaged in protective behaviors in the past three months. Approximately 7% were unlikely or very unlikely to avoid contact with snail-conditioned water, and to use protective behaviors before exposure. Results from SEM analysis indicated that both <i>schistosomiasis</i> knowledge and prior exposure to <i>schistosomiasis</i> were indirectly related to behavior intentions through intrinsic rewards and self-efficacy; prior protective behaviors were indirectly related to behavior intentions through severity, intrinsic rewards and self-efficacy, while awareness had an indirect relationship with behavior intentions through self-efficacy. Among the seven PMT constructs, severity, intrinsic rewards and self-efficacy were significantly associated with behavior intentions.</p><p>Conclusions</p><p>The PMT can be used to predict the intention to engage in protective behaviors against <i>schistosomiasis</i>. <i>Schistosomiasis</i> intervention programs should focus on the severity, intrinsic rewards and self-efficacy of protection motivation, and also increase the awareness of infection, and enrich the contents of <i>schistosomiasis</i> education.</p></div

Structural equation modeling of <i>schistosomiasis</i> knowledge, prior exposure, awareness, protective behavior, <i>schistosomiasis</i> PMT constructs and behavior intention.

<p>The data-model fit indices: GFI = 0.98, CFI = 0.93, RMSEA = 0.06, Chi-square/df = 8.6. **: p<0.01 and *: p<0.05.</p

<i>Schistosomiasis</i> PMT scale.

<p><i>Schistosomiasis</i> PMT scale.</p

Correlations of the <i>schistosomiasis</i> PMT subconstructs with knowledge and behavioral measures.

<p><b>Note</b>:</p><p> **p<0.01,</p><p> *p<0.05.</p><p>Correlations of the <i>schistosomiasis</i> PMT subconstructs with knowledge and behavioral measures.</p

Intention to engage in <i>schistosomiasis</i> protective behaviors.

<p>Intention to engage in <i>schistosomiasis</i> protective behaviors.</p

Knowledge and awareness of <i>schistosomiasis</i> and exposure to snail-conditioned water.

<p>Knowledge and awareness of <i>schistosomiasis</i> and exposure to snail-conditioned water.</p

Prevalence and correlates of marijuana use among HIV-seropositive and seronegative men in the Multicenter AIDS Cohort Study (MACS), 1984–2013

<p><i>Background</i>: Marijuana use is common among HIV+ individuals, but few studies have examined long-term trends in prevalence and correlates of use. <i>Methods</i>: We evaluated trends (1984–2013) in the annual prevalence of current (past 6-month use) and daily (among current users) marijuana use and determined correlates of use among 2742 HIV-seropositive (HIV+) and 3172 HIV-seronegative (HIV−) men who have sex with men in the Multicenter AIDS Cohort Study (MACS). Poisson regression models were used to estimate prevalence ratios of marijuana use separately for the men who were enrolled before 2001 (early-cohort) and after 2001 (late-cohort). <i>Results</i>: Over the 29 years of the study, the prevalence of current marijuana use declined significantly, whereas daily use among users increased among all men in the early and late-cohorts. A HIV+ status was associated with higher prevalence of marijuana use among the men in the early-cohort (adjusted prevalence ratio [aPR] = 1.53, 95% confidence interval [CI]:1.42, 1.64, <i>p</i> = <0.0001), but not in the men in the late-cohort (aPR = 0.90, 95% CI: 0.79, 1.03, <i>p</i> = 0.1424). Alcohol use and cigarette smoking were being positively associated with marijuana use. <i>Conclusions</i>: Although the annual prevalence of current marijuana use decreased significantly over time in the MACS, daily use among users increased significantly. Further, among the HIV+ men, our study did not show clinically significant adverse effects of marijuana use on highly active antiretroviral therapy use, CD4⁺ count, or HIV viral load.</p