Dimensions of self-efficacy among three distinct groups of condom users

Abstract

Condom use self-efficacy can be defined as expectations about one's ability to use condoms under a variety of circumstances. This investigation examined the factor structure of the Condom Use Self-Efficacy Scale (CUSES) in an 18- to 23-year-old college population (N = 339) and tested the ability of the factors to distinguish among three groups of condom users (nonusers, sporadic users, and ritualistic users). Emerging from a principal components analysis were four reliable factors labeled Mechanics, Partner's Disapproval, Assertive, and Intoxicants. Results from a discriminant analysis indicated that sporadic users were best distinguished from ritualistic users by number of sex partners, use of intoxicants, and intensity of alcohol use. The sporadic users had more sex partners, were less confident of their ability to use condoms when intoxicated, and were heavier drinkers than were the ritualistic users. Nonusers were best distinguished from ritualistic users by the factor labeled Assertive. Nonusers were significantly less confident in their ability to discuss condoms and to insist on their use with a sexual partner. Implications of the findings for improving campus-based programs to prevent the spread of human immunodeficiency virus infection and sexually transmitted diseases are discussed.

PIP: During January-June, 1992, 339 students, 18-23 years old, at the State University of New York in Brockport completed a 79-item questionnaire designed to assess sexual behavior and alcohol use. Researchers aimed to test the factor structure of the Condom Use Self-Efficacy Scale (CUSES), which comprised 28 items in the questionnaire, and the ability of self-efficacy, high risk behavior, and demographic factors to differentiate among consistent condom users, sporadic users, and nonusers. Sporadic users had significantly more sexual partners in the last 12 months than did consistent users (3.64 vs. 1.92; p .005). This may be because sporadic users were more likely to use alcohol (CUSES score: 9.09 vs. 7.81; p .05) and to lack confidence in their ability to use condoms when intoxicated (8.5 vs. 9.73; p .005) than were consistent users. Alcohol use had a consistent, positive correlation with number of sexual partners (p .01), indicating the need for college health education programs that promote condom use to address alcohol abuse. Nonusers were less likely to be confident of their ability to demand that their sexual partner use a condom than were consistent users (9.36 vs. 10.58; p .005). They were also more likely to fear partner's disapproval than consistent users (16.46 vs. 17.73; p .05), but this was a more moderate difference than assertiveness. Thus, nonusers tended to be insecure in their abilities to discuss and insist on condom use and to negotiate and resolve any conflict about condom use. Consistent users had better communication skills about intimate subjects than did nonusers. Any health education program promoting safer sexual practices needs to address communication and improvement of relationship skills. These findings also suggest that campus programs cannot be limited to mechanics of condom use, and that role playing would provide students opportunities to practice skills in relationships, communication, and conflict resolution.