Assessing Self-Efficacy and Communication Regarding Sexual Agreements among Men Who Have Sex with Men in the USA: Development and Validation of Two Novel Scales

Torsten B. Neilands, Deepalika Chakravarty, Lynae A. Darbes, Nathan P. O’Brien, Ilse S. Gonzalez and Colleen C. Hoff
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Torsten B. Neilands: Center for AIDS Prevention Studies, Department of Medicine, Division of Prevention Sciences, University of California San Francisco, San Francisco, CA 94158, USA
Deepalika Chakravarty: Center for AIDS Prevention Studies, Department of Medicine, Division of Prevention Sciences, University of California San Francisco, San Francisco, CA 94158, USA
Lynae A. Darbes: Center for Sexuality and Health Disparities, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI 48104, USA
Nathan P. O’Brien: Center for Research and Education on Gender and Sexuality, San Francisco State University, San Francisco, CA 94103, USA
Ilse S. Gonzalez: Center for Research and Education on Gender and Sexuality, San Francisco State University, San Francisco, CA 94103, USA
Colleen C. Hoff: Center for Research and Education on Gender and Sexuality, San Francisco State University, San Francisco, CA 94103, USA

IJERPH, 2021, vol. 18, issue 18, 1-16

Abstract: HIV disproportionately impacts men who have sex with men (MSM) in the USA. Building upon research on relationship constructs unique to MSM couples’ HIV-prevention needs, we developed two new scales measuring sexual agreement self-efficacy (SASE) and importance of sexual agreement communication (ISAC). Following qualitative item development, we used two large independent samples of MSM couples (N1 = 441, N2 = 388) to conduct scale validation. Exploratory factor analyses indicated both SASE and ISAC to be unidimensional with 7 and 5 items (eigenvalues = 5.68 and 3.50), respectively, with strong factor loadings. Confirmatory factor analyses yielded satisfactory model fit for SASE (CFI = 0.99; SRMR = 0.03) and ISAC (CFI = 0.99; SRMR = 0.05). Reliability was high for SASE (? = 0.92) and ISAC (? = 0.84). Predictive validity analysis revealed a protective association between higher scores on both scales and the outcomes of sexual risk behavior and agreement breaks. Convergent and discriminant validity analyses demonstrated associations in the expected directions between these scales and multiple measures of relationship quality. Therefore, SASE and ISAC are two brief, valid, and reliable scales that can facilitate more in-depth explorations of sexual agreements in MSM and thereby contribute greatly to improving our understanding of and ability to intervene on sexual agreements to improve health and relationship outcomes.

Keywords: MSM; self-efficacy; communication; gay couples; sexual agreements; HIV prevention (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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