AIDSQuest: The HIV/AIDS Survey Library
Behavioral and Social Theories Commonly Used
in HIV Research

H. Stages of Change Model

This model, developed early in the 1990s specifically for smoking cessation by James Prochaska, Carlo DiClemente, and colleagues, posits six stages that individuals or groups pass through when changing behavior: pre-contemplation, contemplation, preparation, action, maintenance, and relapse. With respect to condom use, the stages could be described as:

1. Not considering using condoms (pre-contemplation)

2. Recognizing the need to use condoms (contemplation)

3. Thinking about using condoms in the next six months (preparation)

4. Using condoms consistently for less than six months (action)

5. Using condoms consistently for six months or more (maintenance)

6. No longer using condoms consistently (relapse)

In order for an intervention to be successful it must target the appropriate stage of the individual or group and support them in moving from one stage to another. For example, in the initial stage you would most likely focus on providing information so an individual or group wants to enact a desired behavior, while in later stages more skills development would be necessary so that individuals or groups are enabled to enact the behavior. Groups and individuals pass through all stages, but do not necessarily move in a linear fashion.

Much of this information was obtained from Karusa Kiragu and Julie Pulerwitz, "Application of behavior change theory to HIV programs: Lessons learned from operations research at Horizons," unpublished manuscript, with some input from Rachel King's "Sexual behavioral change for HIV: Where have theories taken us?" June 1999.