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Measures of Attitudes Toward and Communication about Condom Use: Their Relationships With Sexual Risk Behavior Among Young Black Men Who Have Sex With Men

Crosby, Richard A. PhD*†‡; Graham, Cynthia A. PhD†‡§; Yarber, William L. HSD†‡§**; Sanders, Stephanie A. PhD†‡¶; Milhausen, Robin R. PhD†‡††; Mena, Leandro MD***

doi: 10.1097/OLQ.0000000000000392
Original Study

Objective The aim of this study was to construct and test measures of psychosocial mediators that could be used in intervention studies seeking to promote safer sex behavior among young black men who have sex with men (YBMSM).

Methods A total of 400 YBMSM, ages 18 to 29 years, were recruited from a clinic for sexually transmitted infection in the southern United States. All men had engaged in penile-anal sex with a man as a “top” in the past 6 months. The men completed an audio-computer–assisted self-interview and provided specimens used for nucleic acid amplification testing to detect Chlamydia and gonorrhea. Four measures were constructed and tested for criterion validity (Safer Sex Communication, Condom Turn-Offs, Condom Pleasure Scale, and a single item assessing frequency of condom use discussions before sexual arousal).

Results With the exception of Safer Sex Communication, all of the measures showed criterion validity for both unprotected anal insertive and unprotected anal receptive sex. With the exception of the Condom Turn-Offs, the 3 other measures were supported by criterion validity for oral sex. Both the Condom Turn-Offs and Condom Pleasure Scale were significantly related to whether or not the men reported multiple partners as a top, but only the Condom Pleasure Scale was associated with reports of multiple partners as a “bottom.” Only the Condom Turn-Offs Scale was positively associated with having been diagnosed with either Chlamydia or gonorrhea.

Conclusion Findings provide 3 brief scales and a single item that can be used in intervention studies targeting YBMSM. Perceptions about condoms being a turnoff and about condoms enhancing pleasure showed strong association with sexual risk behaviors.

This study sample of nearly 400 young black men who have sex with men provided reliability data and evidence of construct validity pertaining to 4 psychosocial mediators often used in safer sex intervention trials.

From the *College of Public Health, University of Kentucky, Lexington, KY; †The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, ‡Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN; §Department of Psychology, University of Southampton, UK; ¶Department of Gender Studies, Indiana University, Bloomington, IN, **Department of Applied Health Science, Indiana University, Bloomington, IN; ††Department of Family Relations and Applied Nutrition, University of Guelph, Ontario, Canada; and ***University of Mississippi Medical Center, Jackson, MS.

Acknowledgment: This study was funded by a grant from the National Institute of Mental Health to the first author, R01MH092226.

Conflict of interest: None declared.

Correspondence: Richard Crosby, PhD, College of Public Health, 151 Washington Ave, Lexington, KY 40506–0003; E-mail:

Received for publication September 9, 2010, and accepted October 29, 2011.

© Copyright 2016 American Sexually Transmitted Diseases Association