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Journal of Behavioral Medicine

, Volume 40, Issue 3, pp 494–505 | Cite as

Psychometric evaluation of the Condom Barriers and Motivations Scale (CBMS)

  • Sarit A. Golub
  • Kristi E. Gamarel
Article

Abstract

The Condom Barriers and Motivations Scale (CBMS) was developed to measure four distinct categories of barriers and motives to condom use, including: risk reduction motivations, pleasure reduction barriers, intimacy interference barriers, and partner pressure barriers. The CBMS is a 16-item scale with four items that correspond to each of these subscales. The CBMS was tested in two samples of gay and bisexual men. Results support the reliability and validity of the scale and its structure. Results also indicate that CBMS subscales are distinct from general measures of sexual wellbeing, personality factors, or relationship quality (i.e., discriminant validity) and are associated with self-reported condom use with different partner types (i.e., construct validity). The CBMS can be helpful in better understanding the dynamics of condom use in the context of pre-exposure prophylaxis decision-making, and can shed light on innovative approaches to enhance condom use as part of comprehensive HIV prevention and sexual health goals.

Keywords

Condoms HIV prevention Measurement Scale 

Notes

Acknowledgements

The authors gratefully acknowledge the hard work of members of the Hunter HIV/AIDS Research Team (HART), including Anthony Surace, Kailip Boonrai, Corina Lelutiu-Weinberger, Inna Saboshchuk, and Louisa Thompson. We also thank Dr. Jeffrey Parsons and the staff at the Center for HIV Educational Studies and Training. We are grateful to the participants who gave their time and energy to this study, and to Dr. Willo Pequegnat and Dr. Michael Stirratt for their support.

Funding

This project was funded by R01MH095565 and R01AA022067 (S.A. Golub, PI) from the National Institutes of Mental Health and Kristi Gamarel was supported by Grant U24AA022000 (D. Operario, PI) from the National Institutes of Alcohol Abuse and Alcoholism.

Compliance with ethical standards

Conflicts of interest

As part of an NIH-funded PrEP Demonstration Project (R01AA022067), Sarit Golub receives study drug and partial support for DBS testing from Gilead Sciences. Kristi Gamarel declares that she has no conflict of interest.

Human and animal rights and Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

References

  1. Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 170–211.CrossRefGoogle Scholar
  2. Alaei, K., Paynter, C. A., Juan, S. C., & Alaei, A. (2016). Using pre-exposure prophylaxis, losing condoms? Preexposure prophylaxis promotion may undermine safe sex. AIDS, 30(18), 2753–2756.PubMedCrossRefGoogle Scholar
  3. Bauermeister, J. A., Carballo-Diéguez, A., Ventuneac, A., & Dolezal, C. (2009). Assessing motivations to engage in intentional condomless anal intercourse in HIV-risk contexts (“bareback sex”) among men who have sex with men. AIDS Education and Prevention, 21, 156.PubMedPubMedCentralCrossRefGoogle Scholar
  4. Berg, R. C. (2009). Barebacking: A review of the literature. Archives of Sexual Behavior, 38, 754–764.PubMedCrossRefGoogle Scholar
  5. Birrell, P. J., Owen, N. G., Delpech, V. C., et al. (2013). HIV incidence in men who have sex with men in England and Wales 2001-10: A nationwide population study. Lancet Infectious Diseases, 13, 313–318.PubMedCrossRefGoogle Scholar
  6. Blechner, M. J. (2002). Intimacy, pleasure, risk, and safety: Discussion of Cheuvront’s high-risk sexual behavior in the treatment of HIV-negative patients. Journal of Gay and Lesbian Psychotherapy, 6, 27–33.CrossRefGoogle Scholar
  7. Brown, I. S. (1984). Development of a scale to measure attitude toward the condom as a method of birth control. Journal of Sex Research, 120, 255–263.CrossRefGoogle Scholar
  8. Burlew, A., Wilson, J., Montgomery, L., Peteet, B., Johnson, C., & Hatch-Maillette, M. (2015). Do masculinity and perceived condom barriers predict heterosexual HIV risk behaviors among black substance abusing men? Journal of Health Disparities Research and Practice, 7, 4.Google Scholar
  9. Campbell, A. N., Brooks, A. J., Pavlicova, M., Hu, M. C., Hatch-Maillette, M. A., Calsyn, D. A., et al. (2016). Barriers to condom use: Results for men and women enrolled in HIV risk reduction trials in outpatient drug treatment. Journal of HIV/AIDS and Social Services, 15, 130–146.PubMedPubMedCentralCrossRefGoogle Scholar
  10. Carver, C. S., & White, T. L. (1994). Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: The BIS/BAS scales. Journal of Personality and Social Psychology, 67, 319–333.CrossRefGoogle Scholar
  11. Catania, J. A., Kegeles, S. M., & Coates, T. J. (1990). Towards an understanding of risk behavior: An AIDS risk reduction model (ARRM). Health Education Quarterly, 17, 53–72.PubMedCrossRefGoogle Scholar
  12. CDC. (2014). Preexposure prophylaxis for the prevention of HIV infection in the United States-2014 clinical practice guideline. Atlanta, GA: Centers for Disease and Control.Google Scholar
  13. Centers for Disease Control and Prevention (CDC). (2015). HIV Surveillance Report, 2013 (Vol. 25). http://www.cdc.gov/hiv/library/reports/surveillance/. Accessed 10 Aug 2016.
  14. Champion, V. L. (1984). Instrument development for health belief model constructs. Advances in Nursing Science, 6(3), 73–87.PubMedCrossRefGoogle Scholar
  15. Crosby, R., Graham, C. A., Yarber, W. L., Sanders, S. A., Milhausen, R., & Mena, L. (2016). Measures of attitudes toward communication about condom use: Their relationships with sexual risk behavior among young black men who have sex with men. Sexually Transmitted Diseases, 43, 94–98.PubMedPubMedCentralCrossRefGoogle Scholar
  16. Crosby, R., Milhausen, R., Yarver, W. L., Sanders, S. A., & Graham, C. A. (2008). Condom “turn offs” among adults: An exploratory study. International Journal of STD andAIDS, 19, 590–594.CrossRefGoogle Scholar
  17. Crosby, R., Yarber, W. L., Sanders, S. A., & Graham, C. A. (2005). Condom discomfort and associated problems with their use among university students. Journal of American College Health, 54, 143–147.PubMedCrossRefGoogle Scholar
  18. DuBois, L. Z., Macapagal, K. R., Rivera, Z., Prescott, T. L., Ybarra, M. L., & Mustankis, B. (2015). To have sex or not to have sex? An online focus group study of sexual decision making among experienced and inexperienced gay and bisexual adolescents. Archives of Sexual Behavior, 44, 2027–2040.PubMedPubMedCentralCrossRefGoogle Scholar
  19. Eaton, L. A., Driffin, D. D., Bauermeister, J., Smith, H., & Conway-Washington, C. (2015). Minimal awareness and stalled uptake of pre-exposure prophylaxis (PrEP) among risk, HIV-negative, Black men who have sex with men. AIDS Patient Care and STDs, 29, 423–429.PubMedPubMedCentralCrossRefGoogle Scholar
  20. Fisher, J. D., & Fisher, W. A. (1992). Changing AIDS-risk behavior. Psychology Bulletin, 111, 455–474.CrossRefGoogle Scholar
  21. Gakumo, C. A., Moneyham, L. D., Enah, C. C., & Childs, G. D. (2012). The moderating effect of sexual pressure on young urban women’s condom use. Research in Nursing and Health, 35, 4–14.PubMedCrossRefGoogle Scholar
  22. Gamarel, K. E., & Golub, S. A. (2015). Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships. Annals of Behavioral Medicine, 49, 177–186.PubMedPubMedCentralCrossRefGoogle Scholar
  23. Gamarel, K. E., Reisner, S. L., Darbes, L. A., Hoff, C. C., Chakravarty, D., Nemoto, T., et al. (2016). Dyadic dynamics of HIV risk among transgender women and their primary male sexual partners: the role of sexual agreement types and motivations. AIDS Care, 28, 104–111.PubMedCrossRefGoogle Scholar
  24. Goedel, W. C., Halkitis, P. N., Greene, R. E., & Duncan, D. T. (2016). Correlates of awareness of and willingness to use pre-exposure prophylaxis (PrEP) in gay, bisexual, and other men who have sex with men who use geosocial-networking smartphone applications in New York City. AIDS and Behavior, 20, 1435–1442.PubMedCrossRefGoogle Scholar
  25. Golub, S. A. (2014). Tensions between the epidemiology and psychology of HIV risk: Implications for pre-ex. AIDS and Behavior, 18, 1686–1693.PubMedPubMedCentralCrossRefGoogle Scholar
  26. Golub, S. A., Starks, T. J., Payton, G., & Parsons, J. T. (2012). The critical role of intimacy in sexual risk behavior of gay and bisexual men. AIDS and Behavior, 16, 626–632.PubMedPubMedCentralCrossRefGoogle Scholar
  27. Grady, W. R., Klepinger, D. H., Billy, J. O., & Tanfer, K. (1993). Condom characteristics: The perceptions and preferences of men in the United States. Family Planning Perspectives, 25, 67–73.PubMedCrossRefGoogle Scholar
  28. Grant, R. M., Lama, J. R., Anderson, P. L., et al. (2010). Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. New England Journal of Medicine, 363, 2587–2599.PubMedPubMedCentralCrossRefGoogle Scholar
  29. Harawa, N. T., Williams, J. K., Ramamurthi, H. C., & Bingham, T. (2006). Perceptions towards condom use, sexual activity, and HIV disclosure among HIV-positive African American men who have sex with men: Implications for heterosexual transmission. Journal of Urban Health, 83, 682–694.PubMedPubMedCentralCrossRefGoogle Scholar
  30. Hart, G. J., & Elford, J. (2010). Sexual risk behaviour of men who have sex with men: Emerging patterns and new challenges. Current Opinions in Infectious Diseases, 23, 39–44.CrossRefGoogle Scholar
  31. Hau, K. T., & Marsh, H. W. (2004). The use of item parcels in structural equation modelling: Non-normal data and small sample sizes. British Journal of Math and Statistical Psycholology, 57, 327–351.CrossRefGoogle Scholar
  32. Helweg-Larsen, M., & Colliins, B. E. (1994). The UCLA Multidimensional Condom Attitudes Scale: Documenting the complex determinants of condom use in college students. Journal of Health Psychology, 13, 224–237.CrossRefGoogle Scholar
  33. Hensel, D. J., Stupiansky, N. W., Herbenick, D., & Dodge, B. (2012). Sexual pleasure during condom-protected vaginal sex among heterosexual men. Journal of Sex Medicine, 9, 1272–1276.CrossRefGoogle Scholar
  34. Higgins, J. A., Tanner, A. E., & Janssen, E. (2009). Arousal loss related to safer sex and risk of pregnancy: Implications for women’s and men’s sexual health. Perspectives in Sex and Reproductive Health, 41, 150–157.CrossRefGoogle Scholar
  35. Higgins, J. A., & Wang, Y. (2015). The role of young adults’ pleasure attitudes in shaping condom use. American Journal of Public Health, 105, 1329–1332.PubMedPubMedCentralCrossRefGoogle Scholar
  36. Hill, B. J., Amick, E. E., & Sanders, S. A. (2011). Condoms and US college-aged men and women: Briefly assessing attitudes toward condoms and gender condom use behaviours. Sexual Health, 8, 372–377.PubMedCrossRefGoogle Scholar
  37. Hoff, C. C., Campbell, C. K., Chakravarty, D., & Darbes, L. A. (2016). Relationship-based predictors of sexual risk for HIV among MSM couples: A systematic review of the literature. AIDS and Behavior, 20, 2873–2892.PubMedCrossRefGoogle Scholar
  38. Jones, R. (2006). Reliability and validity of the Sexual Pressure Scale. Research in Nursing and Health, 29, 281–293.PubMedCrossRefGoogle Scholar
  39. Kahn, J. H. (2006). Factr analysis in counseling psychology research, training, and practice: Principles, advances, and applications. Counseling Psychologist, 34, 648–718.CrossRefGoogle Scholar
  40. Kalichman, S. C., & Rompa, D. (2001). The Sexual Compulsivity Scale: Further development and use with HIV-positive persons. Journal of Personality Assessment, 76, 379–395.PubMedCrossRefGoogle Scholar
  41. Lee, K., & Ashton, M. C. (2004). Psychometric properties of the HEXACO Personality Inventory. Multivariate Behavioral Research, 39, 329–358.PubMedCrossRefGoogle Scholar
  42. Liu, A. Y., Cohen, S. E., Vittinghoff, E., et al. (2015). Pre-exposure prophylaxis for HIV infection integrated with municipal- and community-based sexual health services. Journal of the American Medical Association Internal Medicine, 176, 75–84.Google Scholar
  43. MacKellar, D. A., Valleroy, L. A., Secura, G. M., Behel, S., Bingham, T., Celentano, D. D., et al. (2007). Perceptions of lifetime risk and actual risk for acquiring HIV among young men who have sex with men. AIDS and Behavior, 11, 263–270.PubMedCrossRefGoogle Scholar
  44. Madu, S. N., & Peltzer, K. (2003). Factor structure of condom attitudes among Black South African university students. Journal of Social and Behavioral Perspectives, 31, 265–274.CrossRefGoogle Scholar
  45. Mayer, K. H., & Krakower, D. S. (2015). If PrEP decreases HIV transmission, what is impeding its uptake? Clinical Infectious Disease. http://www.natap.org/2015/HIV/ClinInfectDis2015-Mayer-cid_civ665.pdf. Accessed 10 Aug 2016.
  46. Mimiaga, M. J., Goldhammer, H., Belanoff, C., Tetu, A. M., & Mayer, K. H. (2007). Men who have sex with men: Perceptions about sexual risk, HIV and sexually transmitted disease testing, and provider communication. Sexually Transmitted Diseases, 34, 113–119.PubMedCrossRefGoogle Scholar
  47. Morgan, E., Johnson, I., & Sigler, R. (2006). Gender differences in perceptions of women’s participation in unwanted sexual intercourse. Journal of Criminal Justice, 34, 515–522.CrossRefGoogle Scholar
  48. Operario, D., Nemoto, T., Iwamoto, M., & Moore, T. (2011). Unprotected sexual behavior and HIV risk in the context of primary partnerships for transgender women. AIDS and Behavior, 15, 674–682.PubMedPubMedCentralCrossRefGoogle Scholar
  49. Parsons, J. T., & Bimbi, D. S. (2007). Intentional unprotected anal intercourse among men who have sex with men: Barebacking—From behavior to identity. AIDS and Behavior, 11, 277–287.PubMedCrossRefGoogle Scholar
  50. Parsons, J. T., Halkitis, P. N., Bimbi, D. S., & Borkowski, T. (2000). Perceptions of the benefits and costs associated with condom use and unprotected sex among late adolescent college students. Journal of Adolescences, 23, 377–391.CrossRefGoogle Scholar
  51. Parsons, J. T., Halkitis, P. N., Wolitski, R., & Gomez, C. (2003). Correlates of sexual risk behavior among HIV-positive men who have sex with men. AIDS Education and Prevevention, 15, 383–400.CrossRefGoogle Scholar
  52. Peterson, Z. D., & Muehlenhard, C. L. (2007). Conceptualizing the “wantedness” of women’s consensual and nonconsensual sexual experiences: Implications for how women label their experiences with rape. Journal of Sex Research, 44, 72–88.PubMedGoogle Scholar
  53. Phillips, A. N., Cambiano, V., Nakagawa, F., et al. (2013). Increased HIV incidence in men who have sex with men despite high levels of ART-induced viral suppression: Analysis of an extensively documented epidemic. PLoS ONE, 8, e55312.PubMedPubMedCentralCrossRefGoogle Scholar
  54. Pollack, J. A., & Halkitis, P. N. (2009). Environmental factors in relation to unprotected sexual behavior among gay, bisexual and other MSM. AIDS Education and Prevention, 21, 340–355.CrossRefGoogle Scholar
  55. Prochaska, J. O., Redding, C. A., Harlow, L. L., Rossi, J. S., & Velicer, W. F. (1994). The transtheoretical model of change and HIV prevention: A review. Health Education Quarterly, 21, 471–486.PubMedCrossRefGoogle Scholar
  56. Randolph, M. E., Pinkerton, S. D., Bogart, L. M., Cecil, H., & Abramson, P. R. (2007). Sexual pleasure and condom use. Archives of Sexual Behavior, 36, 844–848.PubMedPubMedCentralCrossRefGoogle Scholar
  57. Reece, M., Herbenick, D., Hollub, A. V., et al. (2010). A psychometric assessment of the Multi-Factor Attitude Toward Condom Scale (MFACS). International Journal of STD and AIDS, 22, 119–129.Google Scholar
  58. Rusbult, C. E., Martz, J. M., & Agnew, C. R. (1998). The investment model scale: Measure commitment level, satisfaction level, quality of alternatives, and investment size. Personal Relationships, 5, 357–391.CrossRefGoogle Scholar
  59. Sacco, W. P., Levine, B., Reed, D. L., & Thompason, K. (1991). Attitudes about condom use as an AIDS-relevant behavior: Their factor structure and relation to condom use. Journal of Consulting and Clinical Psychology, 3, 265–272.CrossRefGoogle Scholar
  60. Schumacker, E. S., & Lomax, R. G. (2010). Structural equation modeling. New York: Routledge, Taylor & Francis Group.Google Scholar
  61. Scott, H. M., & Klausner, J. D. (2016). Sexually transmitted infections and pre-exposure prophylaxis: Challenges and opportunities among men who have sex with men in the US. AIDS Research and Therapy, 13. doi: 10.1186/s12981-016-0089-8.
  62. Scott-Sheldon, L. A., & Johnson, B. T. (2006). Eroticizing creates safer sex: A research synthesis. Journal of Primary Prevevention, 27, 619–640.CrossRefGoogle Scholar
  63. Snell, W. E., Fisher, T. D., & Walters, A. S. (1993). The multidimensional sexuality questionnaire: An objective self-report measure of psychological tendencies associated with human sexuality. Annals of Sex Research, 6, 27–55.CrossRefGoogle Scholar
  64. Starks, T. J., Payton, G., Golub, S. A., Weinberger, C. L., & Parsons, J. T. (2014). Contexualizing condom use: Intimacy interference, stigma, and unprotected sex. Journal of Health Psychology, 19, 711–720.PubMedCrossRefGoogle Scholar
  65. Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics (4th ed.). Boston: Allyn and Bacon.Google Scholar
  66. Theodore, P. S., Durán, R., Antoni, M. H., Fernandez, M. I., & Schneiderman, N. (2004). Intimacy and sexual behavior among HIV-positive men-who-have-sex-with-men in primary relationships. AIDS and Behavior, 8, 321–331.PubMedCrossRefGoogle Scholar
  67. Worthington, R. L., & Whittaker, T. A. (2006). Scale development research: A content analysis and recommendations for best practices. Counseling Psychologist, 34, 806–838.CrossRefGoogle Scholar
  68. Yu, C. Y., & Muthen, B. (2002). Evaluation of model fit indices for latent variable models with categorical and continuous outcomes (Technical Report). Los Angeles, CA: University of California at Los Angeles, Graduate School of Education & Information Studies.Google Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of PsychologyHunter College of the City University of New YorkNew YorkUSA
  2. 2.Basic and Applied Social Psychology PhD ProgramThe Graduate Center of the City University of New YorkNew YorkUSA
  3. 3.Hunter HIV/AIDS Research Team (HART)New YorkUSA
  4. 4.Department of Behavioral and Social Sciences, Center for Alcohol and Addiction StudiesBrown University School of Public HealthProvidenceUSA

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