Safe Sex Behavior Questionnaire

Safe Sex Behavior Questionnaire

COLLEEN DIIORIO,1 Emory University

The Safe Sex Behavior Questionnaire (SSBQ) was designed to measure frequency of use of recommended practices that reduce one’s risk of exposure to, and trans- mission of, HIV.

Description

An information pamphlet sent in May and June of 1988 to all U.S. households by the Surgeon General’s office, Understanding AIDS, was used as a guide to select items that reflect safe-sex practices (DiIorio, Parsons, Lehr, Adame, & Carlone, 1992). All references to safe-sex practices within the pamphlet were identified and classified into one of the following categories: (a) protection during intercourse, (b) avoidance of risky behaviors, (c) avoidance of bodily fluids, and (d) interpersonal skills. Based on these statements, 27 items were written and selected for review by content experts. Experts were asked to evaluate each item for meaning, clarity, and correspondence to the definition of safe-sex behaviors, which were defined as “sexually-related practices, which avoid or reduce the risk of exposure to HIV and the transmission of HIV.” Based on their reviews, all 27 items were retained for the final version, with some minor changes in wording. Following factor analysis, three items were deleted from the scale.

Response Mode and Timing

Each of the 24 SSBQ items is rated on a 4-point scale from 1 (Never) to 4 (Always). The SSBQ takes about 5 to 10 minutes to complete. The items do not usually require explanation.

Scoring

Of the 24 SSBQ items, 15 are worded positively and 9 negatively. The 15 positively worded items are 1, 3, 4, 5, 6, 8, 9, 10, 11, 12, 16, 17, 18, 19, 21. The original items 6, 7, and 16 were deleted from the scale because of the results of factor analysis.

The negatively worded items are reverse coded prior to summing the items. A total score is found by summing responses to the 24 individual items. Total scale scores range from 24 to 96, with higher scores indicating greater frequency of use of safer-sex practices.

Reliability

Initial reliability of the 27-item SSBQ based on responses from a sample of 89 sexually active college students was .82 (coefficient alpha), indicating a moderate degree of internal consistency reliability. Test-retest reliability was assessed using responses from a sample of 100 sexually active college students who completed the scale twice, 2 weeks apart. The correlation was .82, indicating moderate stability. Internal consistency reliability was assessed using a second sample of sexually active college students (N = 531). The alpha coefficient for the 24 items was .82. Based on data collected from a sample (N = 584) of sexually active college students in 1994, the estimated reliability coefficient (Cronbach’s alpha) for the SSBQ 24-item instrument was .82 (DiIorio, Dudley, Lehr, & Soet, 2000).

Validity

Construct validity of the scale was assessed using hypothesis testing and factor analysis. The SSBQ correlated in the predicted directions with the concepts of risk taking and assertiveness (DiIorio, Parsons, Lehr, Adame, & Carlone, 1993). Factor analysis revealed five factors with eigenvalues greater than 1.0: risky behaviors, assertiveness, condom use, avoidance of bodily fluids, and avoidance of anal sex. Three weak items (6, 7, and 16) were identified and dropped to form the 24-item SSBQ.

Other Information

The format of the scale can be modified to use with com- puter-assisted interview (CAI) programs or face-to-face interviews.

Address correspondence to Colleen DiIorio, Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, 1518 Clifton Road NE, Atlanta, GA 30322; e-mail: [email protected]

Safe Sex Behavior Questionnaire

Directions: Below is a list of sexual practices. Please read each statement and respond by indicating your degree of use of these practices.

1 = Never 2 = Sometimes 3 = Most of the Time 4 = Always

		Never	Sometimes	Most of the Time	Always
1.	I insist on condom use when I have sexual intercourse.	1	2	3	4
*2.	I use cocaine or other drugs prior to or during sexual intercourse.	1	2	3	4
3.	I stop foreplay long enough to put on a condom (or for my partner to put on a condom).
		1	2	3	4
4.	I ask potential sexual partners about their sexual histories.	1	2	3	4
5.	I avoid direct contact with my sexual partner’s semen or vaginal secretions.	1	2	3	4
6.	I ask my potential sexual partners about a history of bisexual/homosexual practices.	1	2	3	4
*7.	I engage in sexual intercourse on a first date.	1	2	3	4
8.	I abstain from sexual intercourse when I do not know my partner’s sexual history.	1	2	3	4
9.	I avoid sexual intercourse when I have sores or irritation in my genital area.	1	2	3	4
10.	If I know an encounter may lead to sexual intercourse, I carry a condom with me.	1	2	3	4
11.	I insist on examining my sexual partner for sores, cuts, or abrasions in the genital area.	1	2	3	4
12.	If I disagree with information that my partner presents on safer sex practices, I state my point of view.
		1	2	3	4
*13.	I engage in oral sex without using protective barriers such as a condom or rubber dam.	1	2	3	4
*14.	If swept away in the passion of the moment, I have sexual intercourse without using a condom.
		1	2	3	4

*15.	I engage in anal intercourse.	1	2	3	4
16.	I ask my potential sexual partners about a history of IV drug use.	1	2	3	4
17.	If I know an encounter may lead to sexual intercourse, I have a mental plan to practice safer sex.
		1	2	3	4
18.	If my partner insists on sexual intercourse without a condom, I refuse to have sexual intercourse.
		1	2	3	4
19.	I avoid direct contact with my sexual partner’s blood.	1	2	3	4
*20.	It is difficult for me to discuss sexual issues with my sexual partners.	1	2	3	4
21.	I initiate the topic of safer sex with my potential sexual partner.	1	2	3	4
*22.	I have sexual intercourse with someone who I know is a bisexual or gay person.	1	2	3	4
*23.‌	I engage in anal intercourse without using a condom.	1	2	3	4
*24.	1 drink alcoholic beverages prior to or during sexual intercourse.	1	2	3	4

*Negatively worded items.

© Colleen DiIorio, 2009

References