Key Social Norms Take-aways Social norms—including peer and community expectations, gender dynamics, and religious views—exert indirect but powerful influence on adolescents’ sexual behaviors in rural Tanzania. Although subjective norms were not statistically significant predictors in this study, the broader social environment shaped young people’s sense of agency, their ability to negotiate condom use, and the acceptability of practicing safe sex. Empowerment approaches that go beyond knowledge provision—enabling adolescents to actively participate in health promotion and decision-making—are key to shifting norms and improving behavior.

Objectives To assess the influence of perceived behavioral control, attitudes, subjective norms, and empowerment on the intention to use condoms and reported condom use among adolescents in rural Tanzania.

Methods A cross-sectional survey was conducted with 403 adolescents aged 14–19 from nine randomly selected secondary schools in Newala District, southern Tanzania. Data were collected via a self-administered, pre-tested questionnaire. Measures included socio-demographics, sexual behaviors, and constructs from the Theory of Planned Behavior (TPB) and the Empowerment Model of Health Promotion (EHP). Data analysis involved descriptive statistics, factor analysis, bivariate correlations, and multivariate logistic regression.

Social Norms Measures and Methods Subjective norms were assessed using ten items focused on peer and adult influences (e.g., friends, religious leaders, teachers) and their approval or disapproval of safe sex behaviors, using a Likert scale. While subjective norms were measured as a TPB component, the study found they had only indirect influence on behavior and intention. Empowerment was conceptualized as adolescents’ participation in safe sex promotion activities and access to supportive environments, which more effectively addressed normative constraints.

Results Perceived behavioral control was a significant predictor of intention to use condoms (AOR = 3.06), while empowerment (AOR = 3.69) and positive attitudes (AOR = 3.48) significantly predicted reported condom use. Subjective norms were not significantly associated with either outcome. About 41% of adolescents were sexually active, and nearly half of these did not use condoms at last sex. Many initiated sex between ages 14–17, and condom use remained low despite high intention.

Conclusions The study highlights the value of integrating socio-cognitive and ecological approaches to better understand and address adolescent sexual behavior. Interventions focusing solely on knowledge and attitudes may fall short unless they also tackle empowerment and the broader social environment. Social norms interventions should aim to enhance adolescents’ agency and shift community-level support for safe sex behaviors.