The UCLA Multidimensional Condom Attitudes Scale: documenting the complex determinants of condom use in college students

Abstract

This article describes the development and validation of the UCLA Multidimensional Condom Attitudes Scale (MCAS). The relationships between the MCAS and gender, sexual experience, intentions to use a condom, and past condom use were assessed. The MCAS has five distinct factors: (a) Reliability and Effectiveness of condoms, (b) the sexual Pleasure associated with condom use, (c) the stigma attached to persons who use condoms (Identity Stigma), (d) the Embarrassment About Negotiation and Use of condoms, and (e) the Embarrassment About the Purchase of condoms. The results strongly suggest that condom attitudes are multidimensional and thus cannot meaningfully be summed to a single global score. Results further indicate that men and women hold very different attitudes toward condoms. Implications of scale multidimensionality and directions for future research are discussed.

PIP: Psychology professors from the University of California conducted 3 studies to develop a multidimensional, multiple-indicator condom attitudes scale that would include items drawing upon several independent determinants of condom use. These studies would help them correlate 5 factors of the UCLA Multidimensional Condom Attitudes Scale (MCAS) with other criterion variables to establish the construct validity for each factor in the scale. The first study involved 239 male and female 15-35 year old undergraduate students who completed a 15-page, 187-item questionnaire. The professors used these data to develop 5 domains in the MCAS and to correlate the MCAS with relevant criterion variables. The 5 domains of the MCAS were reliability and effectiveness of condoms, sexual pleasure associated with condom use, stigma attached to persons who use condoms, embarrassment about negotiation and use of condoms, and embarrassment about purchase of condoms. 181 undergraduate students, 18-30 years old, completed a modified questionnaire an item added to improve the identity stigma factor) so the researchers could cross-validate MCAS' domains by means of factor analysis (study 2). Study 3 involved 426 undergraduate students whose data the researchers analyzed to test the 5-factor structure against a 1-factor model, to replicate the factor structure using methods of confirmatory factor analysis in structural equations modeling, and to confirm that the reliability and effectiveness domain included reliability and effectiveness as protection against AIDS, other STDs, and pregnancy. Men were not as embarrassed about buying condoms as women, while women had a more positive attitude towards identity stigma-related issues. Overall, men's and women's attitudes towards condoms were different. The studies' results show that condom attitudes are indeed multidimensional, and that the MCAS goes beyond individual decision making to include the social, interpersonal determinants of sexual behavior.