UCLA Multidimensional Condom Attitudes Scale

UCLA Multidimensional Condom Attitudes Scale‌

MARIE HELWEG-LARSEN,Dickinson College

The purpose of the UCLA Multidimensional Condom Attitudes Scale (MCAS) is to measure condom attitudes in five independent areas: (a) the reliability and effective- ness of condoms, (b) the sexual pleasure associated with condom use, (c) the stigma associated with people proposing or using condoms, (d) the embarrassment about negotiating and using condoms, and (e) the embarrassment about purchasing condoms. The scale can be used with individuals who do and do not have personal experience with condoms.

Description

The 25-item MCAS assesses five independent factors associated with condom use. The MCAS was found to be reliable and valid in three studies using ethnically diverse samples of UCLA undergraduates (Helweg-Larsen & Collins, 1994). As of August 2008 it had been cited 97 times; the scale has been used in 31 of these articles (see companion website at www.routledge.com/text- books/9780415801751 to view the complete list). The scale has been used with a range of populations, such as HIV-positive individuals from urban clinics in California (Milam, Richardson, Espinoza, & Stoyanoff, 2006), Chinese and Filipina American college women (Lam & Barnhart, 2006), sexually active adult cocaine or heroin users (Rosengard, Anderson, & Stein, 2006), cocaine- abusing, opioid-dependent HIV-positive adults entering a methadone program (Avants, Warburton, Hawkins, & Margolin, 2000), individuals in a large public psychiatric hospital diagnosed primarily with schizophrenia and mood disorders (Weinhardt, Carey, & Carey, 1997), American Indian men in New York City who identified as gay/bisexual/two-spirit and heterosexual (Simoni, Walters, Balsam, & Meyers, 2006), and HIV-positive Zambian women (Jones, Ross, Weiss, Bhat, & Chitalu, 2005). Furthermore, the MCAS has been translated to Spanish (DeSouza, Madrigal, & Millan, 1999; Unger & Molina, 1999), Japanese (Kaneko, 2007), and various Zambian languages such as Bemba, Nyanja, and Nsenga (Jones et al., 2005). Overall, the body of research using the MCAS shows that it has been a reliable and valid measure of condom attitudes in a wide range of participants. A complete list of studies which have used the MCAS may be found at the companion website for this book (http:// www.routledge.com/textbooks/9780415801751).

Scoring

We found that the five dimensions of the MCAS cannot meaningfully be summed to generate a single global score because the factors are independent. The statistical independence of the five factors was established via factor analyses and confirmatory factor analysis in structural equation modeling which showed that a model with five independent factors was superior in fitting the data compared to a unidimensional model (all 25 questions averaged). Thus, it is important that the five factors are scored separately. If researchers do not have room to use all 25 questions, they may select one or several of the factors that they are particularly interested in and use all 5 questions in that factor. Another option is to select a few questions from each of the five factors; Table 1 in Helweg-Larsen and Collins (1994) shows factor loadings (separately for men and women) that can guide researchers in the selection of questions. Our research indicates that important information is lost if questions are added together across factors.

Our research also demonstrated the importance of examining condom attitudes separately for men and women. First, results indicated gender differences on several of the five factors; compared to women, men were less embarrassed about purchasing condoms but more concerned about stigma. Second, the MCAS factors showed different patterns of correlations with criterion variables for men and women. For example, women’s past condom use was not correlated with any of the five MCAS factors, whereas men’s past condom use was correlated with positive attitudes toward pleasure and embarrassment about buying condoms.

Some of the MCAS items are worded negatively (i.e., indicate a negative attitude toward condoms), and the score must therefore be reversed before adding or averaging the scores (higher scores will then indicate more positive condom attitudes). The scoring for these items is as follows:

  1. Reliability and Effectiveness of Condoms: Reverse score Questions 6 and 14; then add Questions 4, 6, 9, 14, and 20.
  2. Pleasure Associated With Condoms: Reverse score Questions 2, 8, and 25; then add Questions 2, 8, 15, 19, and 25.
  3. Stigma Associated With Condoms: Reverse score Questions 3, 13, 18, 22, and 24; then add Questions 3, 13, 18, 22, and 24
  4. Embarrassment About Negotiation and Use of Condoms: Reverse score Questions 1, 7, and 16; then add Questions 1, 7, 12, 16, and 21.
  5. Embarrassment About Purchasing Condoms: Reverse score Questions 5, 11, 17, and 23; then add Questions 5, 10, 11, 17, and 23.

Reliability

We established internal consistency in three independent samples (separately for men and women) using factor analysis and confirmatory factor analysis in structural equation modeling (Helweg-Larsen & Collins, 1994). Acceptable Cronbach’s alpha values for each factor have been found in many subsequent studies (e.g., Maisto et al., 2004; Rosengard et al., 2006).

Validity

We established construct validity for the MCAS by showing that gender and sexual experience were associated with the five factors of the MCAS (Helweg-Larsen & Collins, 1994). Furthermore, past and intended condom use was related to the five factors of the MCAS, again showing different patterns for men and women. The MCAS has also been validated in a sample of low-acculturated Hispanic women (Unger & Molina, 1999) and among Mexican undergraduate students (DeSouza et al., 1999).

MCAS Multidimensional Condom Attitudes Scale

Please respond to all questions even if you are not sexually active or have never used (or had a partner who used) condoms. In such cases indicate how you think you would feel in such a situation.

Choose a number on the scale below that best represents your feelings about each statement. There are no right or wrong responses to any of these statements. Write the number that best represents your opinion in the blank beside each question.

Strongly Disagree

Disagree

Slightly Disagree

Slightly Agree

Agree

Strongly Agree

1

2

3

4

5

6

7

        1. It is really hard to bring up the issue of using condoms to my partner.

        2. Use of a condom is an interruption of foreplay.

        3. Women think men who use condoms are jerks.

        4. Condoms are an effective method of preventing the spread of AIDS and other sexually transmitted diseases.

        5. I always feel really uncomfortable when I buy condoms.

        6. Condoms are unreliable.

        7. When I suggest using a condom I am almost always embarrassed.

        8. Condoms ruin the sex act.

        9. I think condoms are an excellent means of contraception.

        10. I don’t think that buying condoms is awkward.

        11. It is very embarrassing to buy condoms.

        12. It is easy to suggest to my partner that we use a condom.

        13. If a couple is about to have sex and the man suggests using a condom, it is less likely that they will have sex.

        14. Condoms do not offer reliable protection.

        15. Condoms are a lot of fun.

        16. I never know what to say when my partner and I need to talk about condoms or other protection.

        17. It would be embarrassing to be seen buying condoms in a store.

        18. People who suggest condom use are a little bit geeky.

        19. The use of condoms can make sex more stimulating.

        20. Condoms are an effective method of birth control.

        21. I’m comfortable talking about condoms with my partner.

        22. Men who suggest using a condom are really boring.

        23. When I need condoms, I often dread having to get them.

        24. A woman who suggests using a condom does not trust her partner.

        25. Condoms are uncomfortable for both parties.

Source. Copyright © 1994 by the American Psychological Association. Adapted with permission. The official citation that should be used in referencing this material is Helweg-Larsen, M., & Collins, B. E. (1994). The UCLA Multidimensional Condom Attitudes Scale: Documenting the complex determinants of condom use in college students. Health Psychology, 13, 224–237.

Address correspondence to Marie Helweg-Larsen, PhD, Department of Psychology, Dickinson College, Carlisle, PA 17013; e-mail: [email protected]

References

Avants, S. K., Warburton, L. A., Hawkins, K. A., & Margolin, A. (2000). Continuation of high-risk behavior by HIV-positive drug users: Treatment implications. Journal of Substance Abuse Treatment, 19, 15–22.

DeSouza, E., Madrigal, C., & Millan, A. (1999). A cross-cultural valida- tion of the Multidimensional Condom Attitudes Scale. Interamerican Journal of Psychology, 33, 191–204.

Helweg-Larsen, M., & Collins, B. E. (1994). The UCLA Multidimensional Condom Attitudes Scale: Documenting the complex determinants of condom use in college students. Health Psychology, 13, 224–237.

Jones, D. L., Ross, D., Weiss, S. M., Bhat, G., & Chitalu, N. (2005). Influence of partner participation on sexual risk behavior reduction among HIV-positive Zambian women. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 82, iv92–iv100.

Kaneko, N. (2007). Association between condom use and perceived bar- riers to and self-efficacy of safe sex among young women in Japan. Nursing and Health Sciences, 9, 284–289.

Lam, A. G., & Barnhart, J. E. (2006). It takes two: The role of partner eth- nicity and age characteristics on condom negotiations of heterosexual Chinese and Filipina American college women. AIDS Education and Prevention, 18, 68–80.

Maisto, S. A., Carey, M. P., Carey, K. B., Gordon, C. M., Schum, J. L., & Lynch, K. G. (2004). The relationship between alcohol and indi- vidual differences variables on attitudes and behavioral skills relevant to sexual health among heterosexual young adult men. Archives of Sexual Behavior, 33, 571–584.

Milam, J., Richardson, J. L., Espinoza, L., & Stoyanoff, S. (2006). Correlates of unprotected sex among adult heterosexual men liv- ing with HIV. Journal of Urban Health—Bulletin of the New York Academy of Medicine, 83, 669–681.

Rosengard, C., Anderson, B. J., & Stein, M. D. (2006). Correlates of condom use and reasons for condom non-use among drug users. The American Journal of Drug and Alcohol Abuse, 32, 637–644.

Simoni, J. M., Walters, K. L., Balsam, K. F., & Meyers, S. B. (2006). Victimization, substance use, and HIV risk behaviors among gay/ bisexual/two-spirit and heterosexual American Indian men in New York City. American Journal of Public Health, 96, 2240–2245.

Unger, J. B., & Molina, G. B. (1999). The UCLA Multidimensional Condom Attitudes Scale: Validity in a sample of low-acculturated Hispanic women. Hispanic Journal of Behavioral Sciences, 21, 199– 211.

Weinhardt, L. S., Carey, M. P., & Carey, K. B. (1997). HIV risk reduction for the seriously mentally ill: Pilot investigation and call for research. Journal of Behavior Therapy and Experimental Psychiatry, 28, 87–95.